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    Government of Telangana: OC BCA BCB BCC BCD BCE SC ST

    Uploaded by

    Kishor Sabade
    This document provides an application form for candidates applying for certain posts under the National Urban Health Mission in Hyderabad District. The application requests information such as the candidate's name, father's name, date of birth, social status, educational qualifications, work experience, address and contact details. The candidate is required to declare that the information provided is correct, and informed that false information could result in cancellation of their candidature.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Government of Telangana: OC BCA BCB BCC BCD BCE SC ST

    Uploaded by

    Kishor Sabade
    78 views3 pages
    This document provides an application form for candidates applying for certain posts under the National Urban Health Mission in Hyderabad District. The application requests information such as the candidate's name, father's name, date of birth, social status, educational qualifications, work experience, address and contact details. The candidate is required to declare that the information provided is correct, and informed that false information could result in cancellation of their candidature.

    Original Description:

    National Urban health dorm

    Original Title

    Application Form

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    This document provides an application form for candidates applying for certain posts under the National Urban Health Mission in Hyderabad District. The application requests information such as the candidate's name, father's name, date of birth, social status, educational qualifications, work experience, address and contact details. The candidate is required to declare that the information provided is correct, and informed that false information could result in cancellation of their candidature.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    78 views3 pages

    Government of Telangana: OC BCA BCB BCC BCD BCE SC ST

    Uploaded by

    Kishor Sabade
    This document provides an application form for candidates applying for certain posts under the National Urban Health Mission in Hyderabad District. The application requests information such as the candidate's name, father's name, date of birth, social status, educational qualifications, work experience, address and contact details. The candidate is required to declare that the information provided is correct, and informed that false information could result in cancellation of their candidature.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    GOVERNMENT OF TELANGANA

    DISTRICT HEALTH SOCIETY, HYDERABAD DISTRICT

    NOTIFICATION No. 6349/NUHM/DM&HO/Hyd/2016-17 Dt:04-01-2017

    RECRUITMENT OF CERTAIN POSTS ON CONTRACT BASIS UNDER


    NATIONAL URBAN HEALTH MISSION

    APPLICATION FORM

    REGISTRATION NO:
    (TO BE FILLED BY THE OFFICE)

    POST FOR WHICH APPLICATION MADE:

    DISTRICT FOR WHICH APPLIED : HYDERABAD DISTRICT (O/o. DM&HO, HYD)

    1.
    Name of the candidate
    2.a
    Name of the Father
    2.b
    Name of Mother
    2.c Paste
    Name of husband/wife
    Photograph here and
    (if married)
    sign across it
    3.
    Sex
    4.
    Date of Birth

    5.
    Social Status (Please
    tick ) OC BC A BC B BC C BC D BC E SC ST

    6. Whether Physically
    handicapped YES / NO
    (Please tick )
    6(a) If yes please mention
    HH / OH / VH
    category (Please tick )

    7. Whether Ex Service
    YES / NO
    man/woman

    p.t.o
    DETAILS OF SCHOOL EDUCATION:

    DISTRICT IN WHICH
    CLASS YEAR OF PASSING
    STUDIED

    IV

    VI

    VII

    VIII

    IX

    DISTRICT TO WHICH CANDIDATE BELONGS AS PER PRESIDENTIAL ORDER

    EDUCATIONAL QUALIFICATIONS:

    NAME OF THE
    QUALIFICATION YEAR OF PASSING
    COLLEGE/UNIVERSITY

    v QUALIFICATIONS FOR EXPERIENCE IN ACCOUNTANCY & COMPUTER COURSE (Filled


    only for the post of Accountant for A&B)

    a) No. of years Which organization/Dept.


    experience etc.,

    b) Experience in Accountancy

    Name of the computer course Year of passing

    MARKS OBTAINED IN THE QUALIFYING EXAMINATION

    Qualifying
    Total Marks Marks Obtained % of Marks Obtained
    Examination

    p.t.o
    ADDRESS PARTICULARS:

    *Name :

    *Father Name :

    *Husband Name :

    *House No. :

    *Street :

    *Village/Town :

    *District :

    *Pin code :

    *Mobile No. : 1) 2)

    *E-mail ID :

    DECLARATION

    I,Smt/Kum/Sri…………………………………………………..D/o/S/o……………………………
    ………certify that above particulars furnished by me are correct to the best of my knowledge. I
    also agree that in the event of any of the particulars furnished in my application being found to be
    incorrect or false at a later date my candidature will be cancelled summarily

    NAME AND SIGNATURE OF THE


    CANDIDATE

    FOR OFFICE USE ONLY

    Date of Receipt of application :

    Candidate has submitted all the attested copies of the certificates as per instructions .All the
    particulars submitted by the individual are verified with respect to the certificates and found
    correct

    Name & Signature of the Supervisor

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