Application Form

Panchayti Raj Department, Govt. of Bihar

Application for Recruitment
Application Details
Application ID :     TAT/0095684 Application Date : 26-Sep-2018 Post Applied For : Technical Assistant
Personal Details
Applicant Name : NISHA KUMARI
Father's /Husband's Name : SHANKAR SINGH
Date of Birth : 15-Feb-1998
Age on (01.08.2018) : 20 Years 5 Months
Gender : Female
Category : GEN
Nationality : Indian
Email ID : nksingh76777@gmail.com
Mobile No. : XXXXXXX2162
Aadhar Type Aadhar No
Aadhar No XXXXXXXX6232
Phone With STD Code :
Physically Handicapped No
Grand Children of Freedom Fighter No

Address for Correspondence

Address : AT-PRABODHI NARENDRA,PO+PS-SARAI,DIST-VAISHALI
Pin Code : 844125

Permanent Address
Address : AT-PRABODHI NARENDRA,PO+PS-SARAI,DIST-VAISHALI
Pin Code : 844125
State of Domicile : Bihar
Home District : VAISHALI
Choice District : SAMASTIPUR

Educational Qualification
  Board/University Specialization State Whether Passing Marks Full Marks Marks
Government or Year Obtained (Excluding Obtained
Private (Excluding Extra  (%)
Extra Subject)
Subject)
I.Matric BSEB Bihar Government 2012 375 500 75
II.Intermediate/12th BSEB Science Bihar Government 2015 362 500 72.4
IV.Diploma SARVEPALLI Diploma in Madhya Private 2018 3313 4100 80.8
RADHAKRISHNAN Civil Pradesh
UNIVERSITY Engineering
V.Additional 0 0 0 0
Qualification

I declare that all the above information is correct to the best of my knowledge and that I shall be liable for punishment if
any information is found incorrect. I also declare that I have understood the guideline for engagement and will fully abide
by the same including any future guideline issued by Panchayti Raj Department in this regard.

Place:-

Date:-
Signature of Applicant