4/27/25, 2:33 PM Registration Slip 2530008299

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BIHAR STAFF SELECTION COMMISSION

P.O.-VETERINARY COLLEGE, PATNA - 800014
ADVERTISEMENT NO. 03/25
FIELD ASSISTANT
PERSONAL DETAILS
REGISTRATION NO.: 2530008299
FORM NO. : 3530008299
NAME OF APPLICANT : BHOLA SHASTRI
FATHER'S NAME : NAGINA PASWAN
MOTHER'S NAME : SANJU DEVI
GENDER : MALE
MOBILE NO. : 9229432927
EMAIL ID : BHOLASHASTRI32512@GMAIL.COM
DATE OF BIRTH : 15-02-2002 LIVE PHOTO

AGE AS ON 01-08-2024 : 22 YEARS, 5 MONTHS, 17 DAYS

NATIONALITY : INDIAN
CATEGORY : SC
DUSADH, DHARI, DHARHI / दुसाध, धारी,
CASTE :
धारही
(EBC/BC-NCLC CERTIFICATE NUMBER) / (SC/ST-CASTE
BCCCO/2025/1898012
CERTIFICATE NUMBER) / (EWS-CERTIFICATE NUMBER) :
ISSUE DATE OF CERTIFICATE : 15-02-2025
CERTIFICATE ISSUING AUTHORITY : RO
PHOTO
DOMICILE OF BIHAR STATE : YES
ISSUE DATE OF DOMICILE CERTIFICATE: 15-02-2025
ISSUE NUMBER OF DOMICILE CERTIFICATE : BRCCO/2025/2482328
DOMICILE CERTIFICATE ISSUING OTHER COMPETENT
RO SIGNATURE IN ENGLISH
AUTHORITY :
ARE YOU PERSON WITH DISABILITY? : NO

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 732801650200)

ID PROOF : AADHAAR CARD ID PROOF NO : 732801650200
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS
NO
REGULAR AND CONTINUOUS SERVICE? :
NUMBER OF ATTEMPTS AFTER BIHAR GOVERNMENT EMPLOYEE? (AFTER DATE: 12-12-
00
2022) :
IDENTIFICATION MARK OF THE CANDIDATE : A MOLE ON RIGHT HAND
ARE YOU AN EX-SERVICEMAN? : NO
WARD OF FREEDOM FIGHTER? : NO
HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION
NO
(UPSC/BOARD/STATE COMMISSION/ANY OTHER)? :
HAVE YOU WORKED UNDER BIHAR GOVERNMENT AFTER BEING RELEASED FROM NCC
NO
AFTER JANUARY 1, 1963?:
WORKED/WORKING AS CONTRACTUAL EMPLOYEE IN BIHAR GOVERNMENT: NO
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

VILL-THARTHARI BAZAR,PO-RAYPUR VILL-THARTHARI BAZAR,PO-RAYPUR
ADDRESS: KOYAL BIGHA,PS- ADDRESS: KOYAL BIGHA,PS-
THARTHARI,NALANDA,BIHAR THARTHARI,NALANDA,BIHAR

VILLAGE/MOHALLA: THARTHARI BAZAR VILLAGE/MOHALLA: THARTHARI BAZAR

POST OFFICE: RAYPUR KOYAL BIGHA POST OFFICE: RAYPUR KOYAL BIGHA
POLICE STATION: THARTHARI POLICE STATION: THARTHARI

DISTRICT: NALANDA DISTRICT: NALANDA

STATE: BIHAR STATE: BIHAR
PIN CODE: 803120 PIN CODE: 803120
EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD / TOTAL MARKS MARKS PERCENTAGE PASSINGDATE CERTIFICATE
UNIVERSITY / OBTAINED NUMBER
INSTITUTE

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4/27/25, 2:33 PM Registration Slip 2530008299
HINDI ENGLISH
MATHEMATICS
10TH /
SANSKRIT BSEB PATNA 500 322 64.40 22-06-2017 171011055145
EQUIVALENT
SCIENCE SOCIAL
SCIENCE
I.SC./10TH HINDI ENGLISH
+2 PHYSICS
BSEB PATNA 500 300 60.00 30-03-2019 0061176
(SCIENCE) CHEMISTRY
I.SC. MATHEMATICS
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 5623531801013
TRANSACTION DATE : 2025-04-27 14:03:15
REGISTRATION FEE (RS.) : 135
DECLARATION DETAILS:
I HEREBY DECLARE THAT THE INFORMATIONS FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I
ALSO DECLARE THAT I HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND
OTHERWISE, I SHALL BE LIABLE FOR ANY LEGAL ACTION AND CANCELLATION OF MY CANDIDATURE.
DATE : 27-04-2025 14:33:29
DECLARATION ACCEPTED : YES

NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.

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