Scribd
Upload
33 views2 pages

Application From

The document is an application confirmation page for a candidate named Kumari Hema Murmu, who is applying for a nursing examination. It includes personal details, communication addresses, educational qualifications, and work experience. The candidate has a BSc in Nursing, one year of experience, and has provided preferences for exam centers in Odisha and Jharkhand.

Uploaded by

Hema Murmu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
33 views2 pages

Application From

The document is an application confirmation page for a candidate named Kumari Hema Murmu, who is applying for a nursing examination. It includes personal details, communication addresses, educational qualifications, and work experience. The candidate has a BSc in Nursing, one year of experience, and has provided preferences for exam centers in Odisha and Jharkhand.

Uploaded by

Hema Murmu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Application Number 241810012634

Do Not Send this Page to National Testing Agency (NTA)


Candidate is requested to retain the printout of Confirmation page for future Reference.

Personal Detail
Have you ever changed
Candidate's Name (As per matriculation
KUMARI HEMA MURMU your name (after NO
certificate)
matriculation)
New Name of the Applicant (As per
Central/State Gazette Notification/any NA Date of Birth 15-02-1998
other authority)
Gender FEMALE Father's Name RAJENDRA NATH MURMU
Mother's Name PANA MONI MURMU Marital Status UNMARRIED
Nationality (Self) INDIAN Nationality (Spouse) NA
Email Address HEMAMURMU1997@GMAIL.COM Mobile Number 7894662578
WHAT IS THE NAME OF
Alternate Conatct No 9693046657 Security Question
YOUR FAVORITE PET?
Security Answer MYNAME Aadhar No 5850
Two visible identification BIRTH MARK IN SIDE
One visible identification mark 3 MOLE IN CHIN
mark LEFT ON KNEE

Communication Details

Correspondence Address

Premises No./Name RAJENDRA NATH MURMU Sub-Locality KALINGA NAGAR


Locality BHUBANESWAR Country INDIA
State ODISHA City KHORDHA
Pincode 751003

Permanent Address

Premises No./Name RAJENDRA NATH MURMU Sub-Locality INDAPAHI


Locality BARIPADA Country INDIA
State ODISHA City MAYURBHANJ
Pincode 757107

Graduation Education Details


Qualification Details BSC. (NURSING) Name of the College SUM NURSING COLLEGE
SIKSHA O ANUSANDHAN
University Full Name Year of Passing 2021
UNIVERSITY
Whether the college is
Percentage of Marks Obtained 64.00 YES
recognized by INC

Additional Education Details


Additional Details (If Any) NO

Experience Details
Nursing Registration
Valid Nursing Registration (Current with
NO
validity dates) ?
NCC Training
Details of NCC training ? NO
Service Experience
How many years of nursing
Service Experience YES 1.00
experience ?
Employment Details
Have you ever been employed ? YES 1. Name of the organisation SUM ULTIMATE HOSPITAL
Start Date of Employment 15-12-2021 End Date of Employment 15-12-2022
Have you previously served in MNS NO

Document Details
Image not found or type unknown

1 PHOTO

Image not found or type unknown

2 SIGNATURE

3 Address Proof (Present and Permanent) View

Exam Center Details


1st Choice For Exam State ODISHA 1st Choice For Exam State BHUBANESWAR
2st Choice For Exam State ODISHA 2st Choice For Exam State BALASORE
3st Choice For Exam State JHARKHAND 3st Choice For Exam State JAMSHEDPUR

You might also like