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Staff Selection Commission: Combined Higher Secondary (10+2) Level Examination 2018

Puja Kumari has applied for the Combined Higher Secondary (10+2) Level Examination 2018 conducted by the Staff Selection Commission. She is a 23 year old female from Patna, Bihar. She has completed her B.Com. (Hons.) and passed her matriculation exam from the Bihar School Examination Board in 2011. She does not have any disability and is seeking the exam to be conducted in Patna as her first preference center. She has declared all information provided in the application as true.

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Rohit Srivastava
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51 views2 pages

Staff Selection Commission: Combined Higher Secondary (10+2) Level Examination 2018

Puja Kumari has applied for the Combined Higher Secondary (10+2) Level Examination 2018 conducted by the Staff Selection Commission. She is a 23 year old female from Patna, Bihar. She has completed her B.Com. (Hons.) and passed her matriculation exam from the Bihar School Examination Board in 2011. She does not have any disability and is seeking the exam to be conducted in Patna as her first preference center. She has declared all information provided in the application as true.

Uploaded by

Rohit Srivastava
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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STAFF SELECTION COMMISSION

BLOCK NO. 12, CGO-COMPLEX, LODHI ROAD, NEW DELHI


110003

COMBINED HIGHER SECONDARY (10+2) LEVEL


EXAMINATION 2018

REGISTRATION NO: 82000094268

APPLICATION IS PROVISIONALLY ACCEPTED


1. NAME AS PER
2. NEW/CHANGED
MATRICULATION 3. FATHER'S NAME 4. MOTHER'S NAME
NAME
CERTIFICATE
PUJA KUMARI - RAMESH SINGH RANJU DEVI
5. DATE OF BIRTH (DD/MM/YYYY) 6. AGE AS ON 01/08/2019 7. GENDER
12/12/1995 23.7 FEMALE
9.1 .IF YES, TYPE OF
9. WHETHER PERSON WITH
8. CATEGORY DISABILITY (OH, HH,VH,
DISABILITY (PWD) ?
OTHERS)
UR NO -
10. NATIONALITY 11. MARK OF VISIBLE IDENTIFICATION
CITIZEN OF INDIA A CUT MARK ON CHIN
12. MATRICULATION (10th CLASS) EXAMINATION 13. MATRICULATION (10th 14. MATRICULATION (10th
BOARD CLASS) ROLL NO CLASS) YEAR OF PASSING
BIHAR SCHOOL EXAMINATION BOARD 710980059 2011
15. PREFERENCE OF EXAMINATION CENTERS
EXAMINATION CENTER ( FIRST ) EXAMINATION CENTER ( SECOND ) EXAMINATION CENTER ( THIRD )
PATNA (3206) MUZAFFARPUR (3205) BHAGALPUR (3201)
17. WHETHER 12th STANDARD PASS IN SCIENCE STREAM WITH
16. MEDIUM OF TYPE TEST MATHEMATICS AS A SUBJECT FROM A RECOGNIZED BOARD OR
EQUIVALENT (FOR C&AG AS DATA ENTRY OPERATOR)
ENGLISH NO
18.1. HAVE YOU ALREADY
JOINED A CIVIL POST BY 18.3. DATE OF DISCHARGE
18.WHETHER EX- 18.2. LENGTH OF SERVICE IN
AVAILING BENEFIT OF FROM ARMED FORCES
SERVICEMAN (ESM)? ARMED FORCES ( IN YEARS )
RESERVATION FOR EX- (DD/MM/YYYY)
SERVICEMAN (ESM) :?
NO - - -
19.1 DO YOU SUFFER FROM CEREBRAL-PALSY:
-
19.2 DO YOU HAVE A PHYSICAL LIMITATION TO WRITE AND SCRIBE IS REQUIRED TO WRITE ON YOUR BEHALF
(CERTIFICATE TO THIS EFFECT FROM THE CHIEF MEDICAL OFFICER/ CIVIL SURGEON & MEDICAL
SUPERINTENDENT OF A GOVERNMENT HEALTH CARE INSTITUTION AS PER NOTICE OF THE EXAMINATION
WOULD BE REQUIRED AT THE TIME OF EXAMINATION)?
NO
19.5 IF SCRIBE IS TO BE
19.4 WILL YOU MAKE YOUR OWN
19.3 WHETHER SCRIBE IS REQUIRED ARRANGED BY SSC, INDICATE
ARRANGEMENT OF SCRIBE?
MEDIUM
NO - -
20. WHETHER SEEKING AGE RELAXATION? 20.1 IF YES,INDICATE CODE
NO -
21. EDUCATIONAL QUALIFICATION
B.COM. (HONS.)

22. DO YOU BELONG TO ECONOMICALLY WEAKER SECTIONS (EWS) ?

NO
23. DO YOU WANT TO MAKE AVAILABLE YOUR PERSONAL INFORMATION FOR ACCESSING JOB OPPORTUNITY IN
TERMS OF DoP&T'S O.M NO.39020/1/2016-ESTT.(B) DATED 21.06.2016 ?
NO

ADDRESS DETAIL
24. POSTAL ADDRESS 25. PERMANENT ADDRESS
AT-LAKHIPUR KOLI, PO-FATEHPUR, PS-GAURICHAK AT-LAKHIPUR KOLI, PO-FATEHPUR, PS-GAURICHAK
DISTRICT: PATNA DISTRICT: PATNA
STATE: BIHAR STATE: BIHAR
PIN: 803206 PIN: 803206
MOBILE NO : 7462966317 EMAIL ID : poojakumari1175@gmail.com
SIGNATURE

FEE PAYMENT AMOUNT TRANSACTION NO TRANSACTION DATE


EXEMPTED - - -
DECLARATION
1. I HAVE READ THE NOTICE OF THE EXAMINATION AND ACCEPT ALL THE TERMS & CONDITIONS OF
THE NOTICE OF THE EXAMINATION.

2. I HEREBY DECLARE THAT ALL STATEMENTS MADE IN THIS APPLICATION ARE TRUE, COMPLETE
AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. I UNDERSTAND THAT IN THE EVENT OF
ANY INFORMATION BEING FOUND SUPPRESSED/FALSE OR INCORRECT OR INELIGIBILITY BEING
DETECTED BEFORE OR AFTER THE EXAMINATION, MY CANDIDATURE/ APPOINTMENT IS LIABLE TO BE
CANCELLED.I AM WILLING TO SERVE ANYWHERE IN INDIA.
PRINT TAKEN ON: 03/04/2019 11:48:41 AM

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