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DME Application

The document is a combined application form for various posts under the Directorate of Medical Education and Health Services in Assam, filled out by a candidate named Sabiruddin. It includes personal details such as the candidate's name, contact information, educational qualifications, and employment exchange registration. The candidate is applying for non-technical posts and has provided relevant academic and certification information.

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sabiruddin7864
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14 views2 pages

DME Application

The document is a combined application form for various posts under the Directorate of Medical Education and Health Services in Assam, filled out by a candidate named Sabiruddin. It includes personal details such as the candidate's name, contact information, educational qualifications, and employment exchange registration. The candidate is applying for non-technical posts and has provided relevant academic and certification information.

Uploaded by

sabiruddin7864
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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GOVERNMENT OF ASSAM

COMBINED APPLICATION FORM FOR FILLING UP POSTS UNDER


DIRECTORATE OF MEDICAL EDUCATION, DIRECTORATE OF HEALTH SERVICES, DIRECTORATE OF HEALTH SERVICES (F/W) ASSAM

Personal Details:
Application No. : 2410041387
Full Name of the Candidate SABIRUDDIN
:
( As per Aadhaar Card/ Pan Card/ Passport )
Candidate's Father's Name : IBRAHIM ALI
Candidate's Mother's Name : SAKINA KHATUN
Candidate's Spouse Name :
Candidate's Date of Birth (DD/MM/YYYY) : 30/11/2001
Gender : MALE
Correspondence Address : VILL: NO.3 MADHAB GOHAIN
: P.O: CHAKARABASTI
: P.S: DALGAON
City : DALGAON
District : DARRANG
State : ASSAM
Pin Code : 784116
Permanent Address : VILL: NO.3 MADHAB GOHAIN
: P.O: CHAKARABASTI
: P.S: DALGAON
City : DALGAON
District : DARRANG
State : ASSAM
Pin Code : 784116
Mobile No. of the Candidate : 7002515308
Alternative Contact No. Telephone / Mobile : 6026138757
E-mail Address of the Candidate : [email protected]
Nationality of the Candidate : INDIAN
Physical identification Marks : NO
: NO
Category of the Candidate : GENERAL
Do you belong to Physically challenged/Divyang?) : NO
Whether Candidate is Permanent Resident of Assam ? : YES
Employment Exchange Registration No. of Assam : : 1447496/01/2023

Do you want to apply for Non - Technical Posts : YES


(Group-5) - Health Educator, (Group-4) - (i) Accountant, (Group-4) -
(ii) Cashier, (Group-8) - Account Assistant, Clerk cum Record
Keeper, Clerk cum Record Keeper cum Computer Operator, Coding
GRADE - III Non Technical Posts : Clerk, Coding Clerk Record Keeper, Computer Operator,
Documentalist, Junior Assistant, LDA Cum Computer Operator,
LDA/Computer Operator cum Clerk, (Group-7) - Health Educator
Cum Sanitary Inspector,
Marks
Marks Percentage Year of Name of School / Board /
Exam Passed Stream Out
Obtained Of Marks Passing College / University
Of
HSLC Or Equivalent (10) : 503 600 83.83 % 25/05/2018 Bechimari HS School
HSSLC Or Equivalent
COMMERCE 410 500 82 % 25/06/2020 Saleha Memorial college
(10+2) :
Graduation : COMMERCE 1258 1480 85 % 30/06/2023 Darrang College
1 YEAR DIPLOMA/CERTIFICATE IN
Diploma Non Technical : 81 100 81 % 02/12/2024 HCF Technical Institute
COMPUTER APPLICATION
Do you have appropriate
computer certification YES
as per advertisment.
Employment Exchange
YES
Registration No.
Employment Exchange
1447496/01/2023
Registration No.

Date: 11/01/2025
15:55:08 Signature of Applicant

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