All India Institute of Medical Sciences, Bhopal Saket Nagar, Bhopal (MP) 462 020 Format for Application PHOTO
1. Name of the post: 2. Name of the candidate: 3. Date of birth: 4. Category: 5. Permanent address: 6. Address for correspondence: 7. Email address: 8. Qualification from Matriculation/ High school and above: S.N.
Qualification Name of Board/ university
Year of passing
Subject
Percentage of marks
9. Experience post qualification S.N.
Post
From Name of Institution
To
Total Duties/ Experience Responsibilities
I, hereby declare that above information provided by me is correct to best of my knowledge and belief. Place Date ------------
---------------------------Signature of the Candidate with name