Registration Number: Bhopal

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Railway Recruitment Board - Online Registration

CEN No.01/2019 for Non Technical Popular Categories(NTPC)


RRB BHOPAL
PRINTED APPLICATION FORM

Registration Number

1510425181
Name MAHIMA DUBEY

Date of Birth 07-11-1999 Gender FEMALE


Father's Name PURUSHOTTAM LAL Mother's Name MANISHA
Matriculation /10th /SSLC Roll number 157243282
Year of Passing Matriculation /10th /SSLC 2015
Mobile Number 8269111372 E-mail ID singhvaibhav52608@gmail.com
Aadhaar Card Status I have Aadhaar Card
Aadhaar Number / Aadhaar Enrollment
876454191034
Number
Applied Qualification 12th (10 +2) OR ITS EQUIVALENT
Community UR (UNRESERVED)
Are you a Widow not re-married /Divorcee not re-married / Judicially Separated not re-married? No
Nationality CITIZEN OF INDIA Religion HINDU
Are you a person with Benchmark Disabilities(PwBD)? No
Are you an Ex - Serviceman? No
Were you domiciled in Jammu and Kashmir during 1.1.1980 to
No
31.12.1989?
Are you an employee in Central Government/ State Government /
No
Public Sector Unit?
Are you a Serving Group C or erstwhile Group D Railway
No
Employee or Casual labour or Substitutes?
Are you an employee in Quasi-admiministrative offices of
Railway Organisation such as Railway canteens, co-operative No
societies and institutes?

PAYMENT DETAILS

Payment Mode Merchant Reference No Transaction ID Transaction Amount


ONLINEPAY 15104251817 CPP9883374 250.00

BANK DETAILS

Do you wish to receive the refund to the same account through which you made the payment? Yes
Bank name A/C Holder name Account Number IFSC Code
-- -- -- --

JOB PRIORITY DETAILS


Category No Post Name(Rly/Prod.Unit) Order of Post Preference
9 COMMERCIAL CUM TICKET CLERK (WCR) 1
9 COMMERCIAL CUM TICKET CLERK (WR) 2
11 JUNIOR CLERK CUM TYPIST (WCR) 5
11 JUNIOR CLERK CUM TYPIST (WR) 6
13 TRAINS CLERK (WCR) 3
13 TRAINS CLERK (WR) 4

DETAILS OF ESSENTIAL QUALIFICATION

Year of
Name of the Exam Board/Discipline/Trade State District Percentage/CGPA/Grade
Passing
Madhya
SSLC/Matriculation State Board Katni 2015 82.5(Percentage)
Pradesh
12TH(+2 STAGE) OR Madhya
State Board Katni 2017 79.2(Percentage)
ITS EQUIVALENT Pradesh

OTHER DETAILS
Mother Tongue Hindi
Choice of Language for Exam Hindi

ADDRESS FOR THE COMMUNICATION


MAKAN NO 102 WORD NO 4 GRAM- SIMRAPATI KATNI BOHARIBAND
Address Line 1
MADHYA
Address Line 2 PRADESH 483330
State Madhya Pradesh District Katni
Classification Village
City / Town/ Village Bahoriband Pincode 483330
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