GOVERNMENT OF ASSAM
COMBINED APPLICATION FORM FOR FILLING UP POSTS UNDER
DIRECTORATE OF MEDICAL EDUCATION, ASSAM
DIRECTORATE OF HEALTH SERVICES, ASSAM
DIRECTORATE OF HEALTH SERVICES (FAMILY WELFAIRE), ASSAM & DIRECTORATE OF AYUSH, ASSAM

Personal Details:
Application No : 220056517
Full Name of the Candidate ( As per Certificate Or Marksheet ) : JINTU DAS
Candidate's Father's Name : NRIPENDRA NATH DAS
Candidate's Mother's Name : HIMANI DAS
Candidate's Date of Birth (DD/MM/YYYY) : 16/10/1991
Gender : MALE
Correspondence Address Line 1 : JYOTINAGAR, PATHSALA, ASSAM
Correspondence Address Line 2 : JYOTINAGAR, PATHSALA
Correspondence Address Line 3 : JYOTINAGAR, PATHSALA
City : PATHSALA
District : BARPETA
Pin Code : 781325
Mobile No. of the Candidate : 8811005753
Alternative Contact No. Telephone / Mobile : 7099417001
E-mail Address of the Candidate : jintudas381@gmail.com
Nationality of the Candidate : INDIAN
Physical identification Marks :
Category of the Candidate : OBC/MOBC(NCL)
Do you belong to Physically challenged/Divyang?) : NO
Whether Candidate is Permanent Resident of Assam ? : YES
 
DEPARTMENT DME (GRADE - III)
Do you want to apply for Department DME (GRADE - III) : YES
Do you want to apply for Department DME Technical (GRADE - III) : NO
Do you want to apply for Department DME Non - Technical (GRADE - III) : YES
Account Assistant, Computer Operator,
Post for DME NON Technical (GRADE - III) :
Junior Assistant,
 
DEPARTMENT DHS (GRADE - III)
Do you want to apply for Department DHS (GRADE - III) : YES
Do you want to apply for Department DHS Technical (GRADE - III) : NO
Do you want to apply for Department DHS Non - Technical (GRADE - III) : YES
Account Assistant cum LDA/Junior
Post for DHS Non Technical (GRADE - III) :
Assistant, Computer Operator, Computor,
 
DEPARTMENT DHSFW (GRADE - III)
Do you want to apply for Department DHSFW (GRADE - III) : NO
 
DEPARTMENT AYUSH (GRADE - III)
Do you want to apply for Department AYUSH (GRADE - III) : NO
 
DEPARTMENT DME (GRADE - IV)
Do you want to apply for Department DME (GRADE - IV) : NO
Do you want to apply for Department DHS (GRADE - IV) : NO
Do you want to apply for Department DHSFW (GRADE - IV) : NO
Do you want to apply for Department AYUSH (GRADE - IV) : NO
Marks
Marks Percentage Year of Name of College
Exam Passed Stream Out
Obtained Of Marks Passing / University
Of
HSLC Or Equivalent
  385 600 64.17 % 23/05/2007 Bajali HS
(10) :
HSSLC Or Equivalent SCIENCE 309 500 61.8 % 21/05/2009 Bajali college
(10+2) :
Royal school of
Graduation : OTHER 2756 4600 59.91 % 27/03/2015
engineering
 
1 YEAR DIPLOMA/CERTIFICATE IN COMPUTER nice computer
Diploma : 70 100 70 % 16/08/2017
APPLICATION education
Do you have appropriate
computer certification YES
as per advertisment.

Date: 13/02/2022
12:48:36 Signature of Applicant