TPSC
Application Form
Post Details
Applied Post / एप्लाइड पोस्ट : General Duty Medical Officer 07/2024
Application No / : 07/2024/0579 Application Status / : Submitted Payment Status / : Paid
आवेदन संख्या आवेदन की स्थिति भुगतान की स्थिति
Personal Information
Candidate's Name / : SUDIPA DEBNATH Mobile No. / मोबाइल : 8794823380 Email Id / इ-मेल आई. :
प्रत्याशी का नाम संख्या डी sudipadebnath28[at]gmail[dot]co
m
Tripura Residence Detail
Are you a Permanent Resident of : Yes PRTC Number : SBM/06/3284
Tripura?
PRTC Issuing District? : South Tripura PRTC Issue date? : 25-05-2007
Identity Details
Has Aadhar : Yes Aadhar no. : xxxxxxxx0927 Nam on Aadhar : SUDIPA DEBNATH
Additional Information
First Name : SUDIPA Middle Name : Last Name : DEBNATH
Father Name / पिता : KHOKAN DEBNATH Mother's Name / माता : SANTI DEBI Gender / लिंग : FEMALE
का नाम का नाम
Mother Tongue : Bengali Date of Birth / : 03-01-1994 Age : 30 Years, 9 Months, 16 Days
जन्मतिथि
Marital Status / : MARRIED Spouse Name : PRANOY SAHA
वैवाहिक स्थिति
Category Reservation
Category / श्रेणी : UR
Subcategory Reservation
Are you Differently Abled Person(PH/Divyang)? / क्या आपको कोई : No
विकलांगता है (पी.एच/दिव्यांग)
Permanent Address Details
House No./Vill/Town : Manubazar P.O./Street Name : Manubazar P.S./Locality : Manubazar
Cityname : Manubazar PINCODE / पिन कोड : 799143 State/UT / राज्य / : TRIPURA
कें द्रीय शासित प्रदेश
District / जिला : South Tripura
Correspondence Address Details
House No./Vill/Town : Agartala P.O./Street Name : Nabadiganta Lane P.S./Locality : Battala
Cityname : Agartala PINCODE / पिन कोड : 799001 State/UT / राज्य / : TRIPURA
कें द्रीय शासित प्रदेश
District / जिला : West Tripura
Other Details
Are you BPL card : NO Are you a govt. : NO Are You Ex- : NO
holder? employee? servicemen? / क्या
आप भूतपूर्व सैनिक हैं?
Whether any : NO Was any court case : No Whether any : No
prosecution is filed against you? disciplinary action
pending in any Court has been initiated by
of Law against you? Government/Semi-
Government
Organisations against
you?
Whether any : NO Whether debarred or : No
disciplinary or any Black listed for
similar action is Examination / SSB /
initiated by Bar University / TPSC /
council or medical Other PSC /UPSC or
council or Association any other
of other Organisations?
Professional/Vocatio
nal Institution?
Physical Standards
Height / ऊं चाई (in cms) : 162
Weight / वजन (in Kgs) : 65
Qualifications Details
Qualification Type / : SSC/Madhyamik Branch/Stream : Result Status : Passed(2010)
योग्यता प्रकार
State / राज्य : TRIPURA Board/University / : TBSE Marks type : MARKS
बोर्ड / विश्वविद्यालय
Out Of : 700 Marks Obtained : 571 Percentage : 81.00
Qualification Type / : HS(10+2) Branch/Stream : science Result Status : Passed(2012)
योग्यता प्रकार
State / राज्य : TRIPURA Board/University / : TBSE Marks type : MARKS
बोर्ड / विश्वविद्यालय
Out Of : 500 Marks Obtained : 356 Percentage : 71.00
Qualification Type / : Degree/Graduate Branch/Stream : MBBS Result Status : Passed(2018)
योग्यता प्रकार
State / राज्य : TRIPURA Board/University / : Tripura University, Marks type : MARKS
बोर्ड / विश्वविद्यालय Suryamaninagar, Tripura West
Out Of : 2450 Marks Obtained : 1458 Percentage : 59.00
Work Experience
Do you have work experience? : No
Employment : Past Experience Type / : Clinical Employer Type / : Government
(Present/Past) / अनुभव का प्रकार सेवारत का प्रकार
सेवारत (वर्तमान / भूतकाल)
Nature of : Temporary From Date / किस तिथि : 03-06-2019 To Date / किस तिथि : 15-09-2020
Employment? / से तक
रोजगार की प्रकृ ति
Name of Post / पद का : Junior Resident Doctor Institution / Department / Organisation / : Indira Gandhi Memorial Hospital
नाम संस्थान / विभाग / संगठन
Employment : Past Experience Type / : Clinical Employer Type / : Government
(Present/Past) / अनुभव का प्रकार सेवारत का प्रकार
सेवारत (वर्तमान / भूतकाल)
Nature of : Temporary From Date / किस तिथि : 03-04-2021 To Date / किस तिथि : 31-08-2023
Employment? / से तक
रोजगार की प्रकृ ति
Name of Post / पद का : Junior Resident Doctor Institution / Department / Organisation / : Indira Gandhi Memorial Hospital
नाम संस्थान / विभाग / संगठन
Employment : Present Experience Type / : Administrative Employer Type / : Government
(Present/Past) / अनुभव का प्रकार सेवारत का प्रकार
सेवारत (वर्तमान / भूतकाल)
Nature of : Temporary From Date / किस तिथि : 01-09-2023 To Date / किस तिथि :-
Employment? / से तक
रोजगार की प्रकृ ति
Name of Post / पद का : Medical Officer (Skill Lab) Institution / Department / Organisation / : National Health Mission
नाम संस्थान / विभाग / संगठन
Critria Details
Have you bachelor degree in MBBS as per schedule(s) of the Indian : Yes
Medical Council Act,1956 ?
Are you completed Internship and also have permanent Registration : Yes
Certificate of any state Medical Council/Medical Council of India ?
Registration Certificate No : 002327
Certificate issuing date : 06-04-2019
Photo & Signature
Photo Signature
Centre Preference
Date : 18-10-2024 Place : AGARTALA Centre Preference : Agartala
Transaction Details
Date : 18-10-2024 10:52:24 Gateway : HDFC Transaction Id : 96d7ecc3312a283ad052
Gateway Transaction : 113508305094 Amount : 447.20 Status : PAID
Id
I SUDIPA DEBNATH hereby declare that I have carefully read the advertisement for this post and all the terms and conditions indicated
therein and undertake to abide by the terms and conditions of this advertisement for participating in the selection process. I fullfill all the
terms and conditions mentioned in the advertisement and the information provided by me herein is true and correct to the best of my
knowledge. I further stipulate that I havecarefully read Government Order No.252-HE of 2012 dated 30.05.2012 and assure that I am not
barred by the provisionsof the said Government Order. I further undertake that I shall not claim any benefit of any qualification/category that
I have not specifically indicated in this online application form. Further, I am aware that I am liable for appropriate penal action, disqualified
from the selection processor loss of the job in the event of selection having been made, if the information provided by me is proved to be
incorrect at any stage.
