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RECRUITMENT FOR THE MULTIPLE POST IN HOSPITAL MANAGEMENT/ADMINISTRATION
SHYAM SHAH MEDICAL COLLEGE, REWA(M.P.)-2019
Fields marked with * are mandatory
Instructions
Documents to be furnished in original at the time of verification of documents along with one set of photocopies attested by a Gazetted officer and a copy of online submitted application form / Receipt
Personal Details
Applying for Post *
Applicant's Name*
Father's/Husband's Name*
Mother's Name*
Category:*
Nationality:*
Gender*
Date of Birth(DD/MM/YYYY)* Age as on 01/07/2019    - -(yy-mm-dd)
Are You Handicap?*
Are you Domicile of MP? *
Employment Registration No. *
Are You an Ex Serviceman*
Type of Handicap?*
Marital Status
Marital Status:* Marriage Date (In DD/MM/YYYY)
No. of Children Last Child Birth Date (In DD/MM/YYYY)
Is Your Last Child Born Twins? Is Your Second Marriage
Educational Qualification
Qualification Name of the Degree/Diploma Stream Passing Year(YYYY) University/Board Institute/College Name Obtained Percent
10th* 10th  
12th* Higher Secondary
Desired Qualification*
* In case your University/Institute does not award marks, please convert grades(CGPA) to Percentage marks and fill.
* Write % of marks with two digits after the decimal. The second digit after the decimal should be rounded off. e.g., if Marks is 60%, then write 60.00%. If marks are 68.938% then write 68.94%.
Other Information
Are You Serving in Government/Corporation/Board/Autonomous Organizations/Nagar Sainik? (If so, the applicant appointment order is compulsory to attach)*
Do you have Knowledge of English and Hindi Typing?*
Do you have Knowledge of Data Feeding?*
Do you have Knowledge of Document scanning?*
Communication Address
Address*
State* City* Pin No.*
Email id* Mobile No.*   Phone No.  
Permanent Address(Same as Communication Address)
Address*
State* City* Pin No.*
Mobile No.* Phone No.
Bank Details
Account Number Bank Name
Account Holder Name IFSC Code
Attachment
Attach Photo with Signature*
Click here for photo sign format
Read form carefully before submission.
I, hereby declare that the above details are true, correct and complete in all respects to the best of my knowledge and belief and nothing has been concealed and in the event of any information being found false/fabricated or any deficiency in the eligibility of the post being detected at a later stage, my candidature is liable to be summarily cancelled/rejected.