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Male Nurse Grade-8 Application Form

This document is an application format for the position of Male Nurse Grade 1 at Bharat Petroleum Corporation Ltd Mumbai Refinery. It requests personal details such as name, gender, marital status, age, qualifications, experience, and contact information. Applicants are advised to submit their completed applications along with photographs and copies of certificates by the last date of May 26, 2022.

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pidgusailaja
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55 views1 page

Male Nurse Grade-8 Application Form

This document is an application format for the position of Male Nurse Grade 1 at Bharat Petroleum Corporation Ltd Mumbai Refinery. It requests personal details such as name, gender, marital status, age, qualifications, experience, and contact information. Applicants are advised to submit their completed applications along with photographs and copies of certificates by the last date of May 26, 2022.

Uploaded by

pidgusailaja
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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BHARAT PETROLEUM CORPORATION LTD

Mumbai Refinery
Application No.
(For office use)
Affix recent
Passport size
Colour
Photograph here
APPLICATION FORMAT FOR MALE NURSE (GRADE-!
[ Put a tick ( ) mark in the appropriate box ]
1. P"#$ a%%&ie' f"r MALE NURSE ( GRADE -
2.
Name "f $)e *an'i'a$e
(In B&"*+ &e$$er#!
3.
Se,- Male / Feale
!. Mari$a& S$a$u#- Marrie" / #narrie"
$.
a! A.e (/r#0 C"m%&e$e'!
a# "n 1231435126 %
b!Da$e Of Bir$) && MM ''''
(. Fa$)er7# name -
). a! D"mi*i&e S$a$e - M"$)er T"n.ue -
b! Ca$e."ry (Pu$ a (! $i*+ mar+ in $)e a%%r"%ria$e b",!
x
*+N
,-C
(N"n-*reamy &ayer!
.C ./ P0& ,1 / 21
Percentage of
&isa3ilit4%
5. C"rre#%"n'en*e A''re##- 6. Permanen$ A''re##-
.tate .tate
Pin Co"e Pin Co"e
17. Nearest 8ail9a4 .tation
11.
C"n$a*$ N"03
M"bi&e N"0
12 e-mai& ID
28. 9UALIFICATION DETAILS (Pu$ a (! $i*+ mar+ in $)e a%%r"%ria$e b",!
2802
B0S* Nur#in. (25
TH
S*i : 6 year#! - /ES 3 NO
C"m%u$er ; Me'i*ine In<en$"ry; E=ui%men$
Han'&in.; P)arma*y; Lab"ra$"ry Te*)ni*ian
>"r+ ? @ ( Ray Te*)ni*ian >"r+ - /ES 3 NO
FULL TIME PART TIME CORRESPONDENCE
2805
PERCENTAGE -AAAAAAAAAAAAAAAAAAA
(Please attach photocopies of all Mar:lists/certificates)
2
ST
CLASS 5
ND
CLASS
2808 INSTITUTE NAME- UNIBERSIT/ 3BOARD-
2806 ENGINEERING GRADUATION LICE B0E3 B0TECH 3 AMIE ETC0 ; C,MP<+/+& / ./#&'=N* / N,/ APP<=CA-<+
2804
AN/ OTHER CERTIFICATE 3 9UALIFICATIONS-
260 /EARS OF E@PERIENCE (AS ON 1201405126!-
==.Previous Experience (=n chronological or"er) > (Attach proof )
Nae of ,rganisation Posts hel"
&uration (exact "ates to 3e gi?en) =n"ustr4
Fro /o
Please specif4 9hether refining/
petroleu/ cheical/petrocheical/
fertilizer in"ustr4@ etc

= here34 "eclare that all the stateents a"e in this application are true an" coplete to the 3est of 4 :no9le"ge. =f at an4 stage of the selection
process@ the a3o?e stateents are foun" to 3e false or incoplete@ = un"erstan" that 4 can"i"ature 9ill stan" cancelle".
Da$e - AAAAAAAAAAAAAAAAAAAA Si.na$ure - AAAAAAAAAAAAAAAAAAAAAAAAAAA
A$$a*) %)"$"*"%ie# "f *er$ifi*a$e# men$i"ne' ab"<e an' any "$)er $e#$im"nia&# in y"ur %"##e##i"n#
T)"#e em%&"ye' in G"<$0 De%$0 3 Pub&i* Se*$"r Un'er$a+in.# #)"u&' a%%&y $)r"u.) %r"%er *)anne&0
In$ere#$e' *an'i'a$e# may #ubmi$ $)eir a%%&i*a$i"n# by %"#$ a&"n. Di$) 5 &a$e#$ %a##%"r$ #iEe %)"$".ra%)#; .i<in. a&& %er#"na& 'e$ai&#
Di$) $e#$im"nia&# an' #u%%"r$in. '"*umen$#; in #ea&e' en<e&"%e #u%er#*ribe' Di$) (P"#$ ( MALE NURSE (GR-! $"F
SR0 MANAGER (ER!; BHARAT PETROLEUM CORPORATION LTD0; MUMBAI REFINER/; MAHUL ; MUMBAI ( 611 1G60
LAST DATE FOR RECEIPT OF COMPLETED APPLICATION IS 2H01405126

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