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Recruitment For Paramedical Staff
Fields marked with * are mandatory
Instructions
  1. 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
  2. For Application Submission OTP is Required which will be send to Your Registered Email ID and Mobile Number.Kindly Fill the Valid Email ID and Mobile Number.
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 01/01/2021    - -(yy-mm-dd)
Are you Domicile of MP? *
Are You an Ex Serviceman?*
Are You Physically Handicapped?*
*
Employment Registration Number *
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 Percentage (00.00)
8th* 8th  
10th * 10th  
12th * Higher Secondary
PG
M.Phil*
Do You Have Passed Degree/Diploma/Certificate From Govt. Medical College/Govt. College? *
* 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 Yes so, the applicant NOC is compulsory to attach)*
Do You Have Certificate Course in Computer Operations (Minimum Two Months)?*
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
City preferences for Qualifying Examination Center
First Preference * Second Preference * Third Preference *
Read form carefully before submission.
I, HEREBY DECLARE THAT ALL THE INFORMATION GIVEN IN THE AFOREMENTIONED ACCORDING TO POST OF APPLICATION FORMAT IS TRUE TO THE BEST OF MY KNOWLEDGE. I UNDERTAKE AND ACCEPT THAT IF ANY OF THE INFORMATION GIVEN BY ME IS FOUND TO BE INCORRECT, THEN MY APPLICATION WILL BE REJECTED AND IF APPOINTED, THEN MY APPOINTMENT WILL BE TERMINATED & ACTION MAY BE TAKEN ACCORDINGLY.