JAMIA HAMDARD
HAMDARD NAGAR, NEW DELHI Please paste duly
attested photograph
Application Form for Non-Academic and Technical Posts here while sending
this application form
by post.
1. Advertisement No. : 1/2019
2. Post applied for : Veterinary Officer
3. Bank Draft/Cheque No. : 136851 Date: 07/10/2019
4. Name : SANDEEP DWIVEDI
5. Father’s/Husband’s Name : TARUNENDRA DWIVEDI
6. Date of Birth: : 15/07/1989
7. Marital Status : Married/Unmarried
8. Whether you belong to (please select) SC …….. ST …… OBC …… Gen …… PH ……………
(Attach Certificate, if belong to SC, ST, OBC or PH)
9. Nationality : INDIAN
10. Permanent Address : H.NO 6, VILLAGE POST JANARDANPUR
TEHSIL-RAMPURBAGHELAN, DISTRICT-SATNA
MADHYA PRADESH
Pincode: 485111
11. Mailing Address : VENKETESHWARA HATCHERIES LAYER DIVISION
BESIDE INDIAN OIL CORPORATION, VILLAGE-THIMMAPUR
MANDAL-KOTHUR, DISTRICT- RANGAREDDY, TELANGANA
Pincode: 509325
Work Phone : +919630837738
Residence Phone : +917000162148
Email : sandeepdwivedi1508@gmail.com
12. **Educational Qualifications (In choronogical order from Secondary School onwards)
Examination Subject (s) Division or Percentage of Year University/Institution
Passed Specialization Equivalent Marks
MVSc Veterinary Pathology First 80 2018 Nana ji Deshmukh
Veterinary Science
Universtiy, Jabalpur
BVSc & A.H. Animal and Veterinary First 79 2016 Nana ji Deshmukh
science Veterinary Science
Universtiy, Jabalpur
HSC PCB First 65.77 2007 MPBSE, ECI School
Rewa (MP)
SSC Not Applicabe First 76 2005 CBSE, Kendriya
Vidyalaya, Rewa,
(MP)
13. Employment Records:
(In chronological order starting from the present job):
Name & Address Designation of Period Nature of duties Scale of Pay
of the employer Post held
From To
Venketeshwara Assistant 08/10/18 08/10/19 Poultry disease Not Applicable
Hatcheries, Manager diagnosis, Basic pay:
Hyderabad Techincal Layers and Rs 16500/-
services Broilers Beeder
health
management
14. Are you willing to accept the minimum initial pay in the grade? If not, state reasons for claiming
higher starting pay.
……………………YES……………………………..
15. Indicate the time required to join, if selected: ONE MONTH
16. Any other information you may wish to add
Being a Veterinary Pathologist and Postgraduated from the Institute having Lab Animal Facility, i am
well aquainted with their handling, blood collection, treatment and management. I posses strong interest in
preclinical studies and toxicopathology work concerned with Drug development. I am having knowledge of
GLP and CPCSEA guidelines.
17. References (Please specify the names of two referees who should be responsible persons and
well acquainted with you for the last five years. If employed, one of the referees should be
present or most recent employer.)
(a) Name : Dr. RPS Baghel
Designation : Dean
Address : College of Veterinary Science and Animal Husbandary MHOW
(MP)
E Mail: deanvetmhow9@gmail.com
Phone : +919425863305
(b) Name : Dr. Madhu Swamy
Designation : Professor and Head
Address : Department of Veterinary Pathology
College of Veterinary Science and Animal Husbandary
Jabalpur (MP) 482001
E Mail: vetpath@rediffmail.com
Phone : +919826146091
18. Please attach extra sheet (with hard copy of application only) indicating your suitability for this post.
………………………………………………………………………………………………………..
………………………………………………………………………………………………………..
DECLARATION
I certify that the foregoing information is correct and complete to the best of my knowledge and belief
and nothing has been concealed/distorted. If I am found to have concealed/distorted any material
information my appointment shall be liable to be summarily terminated without notice/compensation.
…………………………..
Signature of the Applicant
Annexure- B
JAMIA HAMDARD
HAMDARD NAGAR, NEW DELHI-62
DETAIL OF QUALIFICATIONS & EXPERIENCE OF THE CANDIDATE APPLIED FOR THE
BELOW MENTIONED POST IN RESPONSE TO ADVERTISEMENT NO. __1/2019____DATED
__23/September/2019
POST APPLIED FOR: Veterinary Officer
S. No. Name & Address Qualification
SANDEEP DWIVEDI Course Stream/ Div/% Year University
HOUSE NUMBER 06 Subject
VILLAGE
POST:JANARDANPUR PG/Master’s VETERINARY 80.00% 2018 NANAJI
TEH; Degree PATHOLOGY DESHMUKH
RAMPURBAGHELAN VETERINARY
(MVSc) SCIENCE
DISTT: SATNA
STATE: M.P. UNIVERSITY
PIN: 485111 JABALPUR,
(M.P.) 482001
Graduation ANIMAL AND 79.00% 2016 NANAJI
(BVSc & VETERINARY DESHMUKH
SCIENCE VETERINARY
A.H.) SCIENCE
UNIVERSITY
JABALPUR,
(M.P.) 482001
Diploma
(Subject)
Other
Work Experience:
1. ONE YEAR OF EXPERIENCE AS ASSITANT MANAGER, VENKETESHWARA
HATCHERIES POULTRY DISEASE DIAGNOSTIC CENTRE HYDERABAD
DOB: 15/07/1989 Age as on last date :__30_Years__2_Month(s)_27__Day(s)
Total Experience: _ 1 Year
Present Scale of Pay/Salary: Basic pay : Rs. 16500/- Present Salary: Rs. 48792/-
Time required to Join: One Month
…….…………….
(END)
