GOVERNMENT OF ASSAM
COMBINED APPLICATION FORM FOR FILLING UP POSTS UNDER
DIRECTORATE OF MEDICAL EDUCATION, ASSAM
Personal Details:
Application No. : 2310113445
Full Name of the Candidate ARIFUDDIN AHMED
:
( As per Aadhaar Card/ Pan Card/ Passport )
Candidate's Father's Name : AFTABUDDIN AHMED
Candidate's Mother's Name : GULENA BEGUM
Candidate's Spouse Name :
Candidate's Date of Birth (DD/MM/YYYY) : 22/03/1999
Gender : MALE
Correspondence Address : HALWATING, NEPALI BOSTI
: PO. MADHAB NAGAR
: PS. HALWATING
City : SIVSAGAR
District : SIVASAGAR
State : ASSAM
Pin Code : 785681
Permanent Address : HALWATING, NEPALI BOSTI
: PO. MADHAB NAGAR
: PS. HALWATING
City : SIVSAGAR
District : SIVASAGAR
State : ASSAM
Pin Code : 785681
Mobile No. of the Candidate : 9085811408
Alternative Contact No. Telephone / Mobile : 0361
E-mail Address of the Candidate : [email protected]
Nationality of the Candidate : INDIAN
Physical identification Marks : BLACK MOLE ON LEFT INDEX FINGER
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 : : 9260124/12/2021
GRADE - III POSTS
Do you want to apply for Technical Posts : NO
Do you want to apply for Non - Technical Posts : YES
LDA/Computer Operator cum Clerk/DTP Operator, Health
Assistant (Male), Documentalist, Receptionist-cum-Clerk,
Record Clerk, Record Keeper cum Clerk cum Computer Operator,
GRADE - III Non Technical Posts :
Store Keeper cum Clerk cum Computer Operator, Store Keeper-
cum-Record Clerk, Health Educator, Library Assistant,
Accountant, Cashier, Account Assistant, Computer Operator,
GRADE - IV POSTS
Do you want to apply (GRADE - IV) POSTS : NO
Marks
Marks Percentage Year of Name of School / Board /
Exam Passed Stream Out
Obtained Of Marks Passing College / University
Of
HSLC Or Equivalent AMGOORIE HALOWATING
484 600 80.66 % 02/06/2015
(10) : MAZDUR HIGH SCHOOL
HSSLC Or
COMMERCE 405 500 81 % 30/05/2017 A H D H S SCHOOL
Equivalent (10+2) :
Graduation : COMMERCE 1523 2400 63.46 % 03/02/2021 DIBRUGARH UNIVERSITY
Diploma Non 1 YEAR DIPLOMA/CERTIFICATE IN THE MODEL COMMERCIAL
68 100 68 % 15/06/2019
Technical : COMPUTER APPLICATION INSTITUTE, JORHAT
Do you have
appropriate
computer
YES
certification
as per
advertisment.
Date: 06/01/2025
21:33:22 Signature of Applicant
