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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 by Pabitra Pegu. It includes personal details, educational qualifications, and employment exchange registration information. Pabitra is applying for non-technical posts and has provided relevant contact and identification information.

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26 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 by Pabitra Pegu. It includes personal details, educational qualifications, and employment exchange registration information. Pabitra is applying for non-technical posts and has provided relevant contact and identification information.

Uploaded by

dayallbenny
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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. : 2410084487
Full Name of the Candidate PABITRA PEGU
:
( As per Aadhaar Card/ Pan Card/ Passport )
Candidate's Father's Name : GHANAKANTA PEGU
Candidate's Mother's Name : INDESWARI PEGU
Candidate's Spouse Name :
Candidate's Date of Birth (DD/MM/YYYY) : 11/04/1999
Gender : MALE
Correspondence Address : NO.2 ARIMORA VILLAGE, JONAI
: PO - RATANPUR, JONAI
: PIN-787060
City : JONAI
District : DHEMAJI
State : ASSAM
Pin Code : 787060
Permanent Address : NO.2 ARIMORA VILLAGE, JONAI
: PO - RATANPUR, JONAI
: PIN-787060
City : JONAI
District : DHEMAJI
State : ASSAM
Pin Code : 787060
Mobile No. of the Candidate : 6002776212
Alternative Contact No. Telephone / Mobile : 03758
E-mail Address of the Candidate : [email protected]
Nationality of the Candidate : INDIAN
Physical identification Marks : Cut marks on the right side of forehead
Category of the Candidate : ST(P)
Do you belong to Physically challenged/Divyang?) : NO
Whether Candidate is Permanent Resident of Assam ? : YES
Employment Exchange Registration No. of Assam : : 2088130/04/2022

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


(Group-12) - Statistician, Statistical Assistant, (Group-5) - Health
Educator, (Group-10) - Library Assistant, Assistant Librarian,
(Group-8) - Account Assistant, Clerk cum Record Keeper, Clerk
cum Record Keeper cum Computer Operator, Coding Clerk,
GRADE - III Non Technical Posts :
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, (Group-11) - Laboratory Assistant,
Marks
Marks Percentage Year of Name of School / Board
Exam Passed Stream Out
Obtained Of Marks Passing / College / University
Of
Jawahar Navodaya
HSLC Or Equivalent (10)
380 500 76 % 28/05/2016 Vidyalaya, Dhemaji,
:
Assam
Jawahar Navodaya
HSSLC Or Equivalent
SCIENCE 290 500 58 % 26/05/2018 Vidyalaya, Dhemaji,
(10+2) :
Assam
Murkong selek college,
Graduation : ARTS 360 500 72 % 04/07/2023
Jonai, Dhemaji, Assam
1 YEAR DIPLOMA/CERTIFICATE IN Arcade Computer
Diploma Non Technical : 306 400 76.5 % 29/08/2023
COMPUTER APPLICATION Academy
Do you have appropriate
computer certification YES
as per advertisment.
Employment Exchange
YES
Registration No.
Employment Exchange
20881/04/2022
Registration No.

Date: 15/01/2025
18:55:02 Signature of Applicant

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