3/1/2018 Applicant Print

Railway Recruitment Board - Online Registration

APPLICATION FORM

Registration No. 1580205628

RRB Unit Bhopal

Name VARUN PATHAK

Date of Birth 05-11-1994 Gender MALE

CHANDRABHAN
Father's Name Mother's Name SAVITA
PATHAK
Matriculation/10 th/SSLC Roll number / ITI / NAC Certificate Number 192420781
Year of Passing Matriculation/10th /SSLC / ITI / NAC 2009
Mobile Number 7692007012 E-mail ID lalupathak7692@gmail.com
Aadhaar Card Status I have Aadhaar Card
Aadhaar Number / Aadhaar Enrollment Number 667698971574
Qualification 10th PASS ONLY
Community UR (UNRESERVED)
Nationality CITIZEN OF INDIA Religion HINDU
Are you a person with Disabilities(PWD)? No
Are you an Ex - Serviceman? No
Have you Course Completed Apprenticeship under Act 1961? No
Domiciled in Jammu and Kashmir during 1.1.1980 to 31.12.1989 No
Are you an employee in Central Government/ State Government / Public
No
Sector Unit?
Are you a Serving Group C / Group D Railway Employee / Casual labour
No
and Substitutes?
Are you an employee in Quasi-admiministrative offices of Railway
No
Organisation?
Do you belong to Economically Backward Class? Yes
Would you like to avail fee concession and refund facility? No

PAYMENT DETAILS
Payment Mode Merchant Reference No Transaction ID Transaction Amount
ONLINEPAY 715003272751580205628 IGACZXVTX1 500.00

JOB PRIORITY DETAILS

Category No Post Name(Rly/Prod.Unit) Order of Post Preference
26 ASSISTANT POINTSMAN 1
28 PORTER / HAMAL / SWEEPER CUM PORTER 2

DETAILS OF ESSENTIAL QUALIFICATION

Year of Date of
Name of the Exam Board/Discipline/Trade State District Percentage/CGPA/Grade
Passing Result
Madhya
SSLC/Matriculation State Board Sagar 2009 -- 66.16(Percentage)
Pradesh

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3/1/2018 Applicant Print

OTHER QUALIFICATION
Details of other qualification if any Post Graduate
Subject Stream(for Under & Post Graduate) COMMERCE

OTHER DETAILS
Mother Tongue Hindi
Choice of Language for Exam other than English Hindi

ADDRESS FOR THE COMMUNICATION

Address Line 1 VILLAGE DHULTARA
Address Line 2 DEORI
State Madhya Pradesh District Sagar
Classification Village
City / Town/ Village Deori Pincode 470226

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