Government Medical College and Hospital
Sector 32, Chandigarh
Application Form for the Post of Staff Nurse
(Note : Do not send this to GMCH)
Application Detail
Post Applied For : Staff Nurse
Application ID : 1982210262825
Date of Apply : 13/10/2018
Name of Candidate : shakuntla
Father's/Husband Name : RAJPAL SINGH
Sex : Female
Category Code : General
Registration No : 27415
Registration Date : 24/11/2016
State in which registered : PUNJAB
Date of Birth : 21/02/1982
Present Address : H NO 2294A SECTOR 19C CHANDIGARH
e-mail ID : shakuntla_sajwan@yahoo.co.in
Phone No :
Mobile No : 9501007785
Permanent Address : H NO 2294A SECTOR 19C CHANDIGARH
Amount : 500
ICT skill from NIELIT : Yes
If belongs to OBC category, mention caste & Sr. No. in the U.T. Chandigarh OBC List in the
following fileds:
Caste :
Whether candidate himself/ : 0
herself is Ex-servicemen or
Lineal Descendent of Ex-
servicemen.
If Self Ex-servicemen, mention following :
(a)(i) Discharge Book No. :
(a)(ii)Date of Issue :
(b)(i) Identity Card No. :
(b)(ii)Date of Issue :
If Lineal Descendent/Widow of Ex-servicemen mention following :
Number :
Date of issue of Lineal :
Descendent certificate
Mention District & State :
Married/Unmarried : Married
Educational and Professional Qualification :
Exam University Subject Offered Year/Sessio Max Marks Obt.
Passed n Marks
GNM PUNJAB MIDWIFERY, 2004 1200.00 817.00
NURSES COMMUNITY
REGISTRATIO HEALTH Ng II
N COUNCIL
B.Sc BABA FARID SOCIOLOGY, CHN, 2013 1900.00 1394.00
(Nursing) UNIVERSITY MHN, NSG ADM,
OF HEALTH NSG EDU,
SCIENCE RESEARCH
M.Sc BABA FRID NURSING 2015 1300.00 837.00
(Nursing) UNIVERSITY MANAGEMENT,
OF HEALTH DISSERTATION and
SCIENCES VIVA,
OBSTETRTICAL
NURISNG II
Signature of Candidate