National Health Mission Microbiology Job With Rs. 60,000 Salary pm

NATIONAL RURAL HEALTH MISSION, HARYANA Application for the post of ________________________ 1.

Name of the candidate

:

______________________________

2.

Father’s/Husband Name

:

______________________________

3.

4.

Sex Date of Birth (DD/MM/YYYY)

: :

Male / Female __________________________________________

5.

Category to which belong

:

__________________________________________

6.

Telephone / Mobile No.

:

__________________________________________

7.

E-mail

:

__________________________________________

8.

Permanent Address

:

____________________________________________________

Paste Passport Size Photo Here

____________________________________________________ __________________________PIN CODE ________________ 9.

Correspondence Address

:

____________________________________________________ ____________________________________________________ __________________________PIN CODE ________________

10. Educational / Professional Qualifications : Examination Board/ Year of Maximum Marks Passed University Passing Marks Obtained 10th

10+2 / Vocational / Intermediate

Graduation

Post Graduation

Any other Course / Diploma etc

%age Division of marks

Subject

11. Internship / Training (if any): Year(s)______ Month(s) _______ Day(s) ________ Name of Institution / Designation From To Organization

12. Total Experience: Year(s)______ Month(s) _______ Day(s) ________ Name of Institution / Designation From To Organization

13

Detail of document attached

:

Total period

Pay/Salary / Honorarium p.m.

Total period

_____________________________________________________

14. Declaration : I hereby declare that 1.

2.

3.

All statements made in this application form are true, complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect, or ineligibility being defected before or after the interview/selection/appointment, my candidature may be cancelled and action can be taken against me by the commission.

I have read the provisions in advertisement of the omission carefully and I hereby undertake to abide by them. I fulfill all the conditions of eligibility regarding age limits, educational qualifications etc. prescribed in the advertisement and other relevant rules and instructions.

I have never been convicted by criminal court.

Date : ______________ Place : _____________

Signatures of the Candidate