Kakrapar Gujarat Site [ Advt No. Kakrapar Gujarat Site/HRM/01/2018 ] ONLINE APPLICATION 1. Name of the Post applied for Nurse 'A' - Nursing 2. Application Number 1820NANR001719 3. Full Name HIRDAYA RAJ SINGH 4. Father's Name HIMMAT SINGH 5. Mother's Name SHANTRA KANWAR 6. Date of Birth (in DD/MM/YYYY 24/05/1986 format) 7. Age as on 25/10/2018 32 Years 5 Months 1 Days Age Relaxation availed: YES 8. Nationality Indian 9. Gender Male 10. Marital Status Single 11. Religion Hindu 12. Category OBC (Non Creamy Layer) 13. Mother Tongue RAJASTHANI 14. PwBD NO 15. Whether NPCIL Employee NO 16. State/UT of Domicile RAJASTHAN 17. Educational Qualifications Exam Degree Discipline College/In Board/Uni Mode of Mon/Year Mon/Year Aggregate Passed stitute versity Study of of Passing (%) Enrolment SSC SSC SARASWA BSER 5 / 2001 6 / 2002 60 TI AJMER SCHOOL HSC HSC PCB SUSHIL BSER 5 / 2004 5 / 2005 56.77 PUBLIC AJMER SCHOOL Diploma Diploma Nursing & SURABHI KARNATA Full Time 8 / 2009 2 / 2015 68.12 Mid-Wifery INSTITUTE KA OF NURS Graduatio n Certificate
Date of Notification of Result/Issue of Final Marks Sheet for Trade
Certificate / Certificate. Date of Notification of Result/Issue of Final Marks Sheet for Diploma. 28/02/2015 Date of Notification of Result/Issue of Final Marks Sheet for Graduate Degree. Are you registered as a Nurse with Central or State Nursing Council in YES India? Are you Nursing Assistant Class III and above from the Armed Forces? NO 18. Other Qualifications Name of Qualification Subject / Specialization Institute / University Mon/Year of Passing
19. Details of Post Qualification Experience, if any
Name of Type of Orgn. Post Held Nature of Date From Date To Serving Employer Duties Presently KMS Private Sector NURSING GOOD 04/03/2015 25/07/2017 NO HOSPITAL OFFICER
Total Experience 2 Years 4 Months 22 Days
20. Other Details Aadhaar Number Are you a dependent of those who NO died in the riots of 1984 (Dep1984)? Are you Physically domiciled in NO Kashmir Division of Jammu Kashmir State from 01/01/1980 to 31/12/1989 (Dom Kashmir)? Are you an Ex-servicemen? NO Level of Computer Literacy: MS WORD,MS EXCEL,MS POWERPOINT,INTERNET OPERATIONS. Have you worked with NPCIL on NO Contract/Fix Term basis? Are you registered with any NO Employment Exchange? Are any of your close relatives NO employed in NPCIL/DAE? 21. Application Fee Details Application Fee not applicable. 22. Correspondence Address 23. Permanent Address S-39INDRA VERMA COLONY 37 KHAR JAGA BASTI SASEDI SHASTRINAGAR AKOLPURA KAURALI District JAIPUR District KAROULI State RAJAST Pin 302016 HAN Code State RAJAST Pin 322249 HAN Code Contact 7877448107 Contact 7877448107
24. Nearest Railway Station Jaipur junction
25. Contact Details Mobile No. 7877448107 Email ID dilrajnsg@gmail.com
Declaration by the Candidate
(i) I hereby declare that I am eligible to apply for the post as specified in the Advertisement / Internal Circular. (ii) I hereby declare that all statements made in the application are true to the best of my knowledge and belief. (iii) I am aware that my application is liable to be rejected if the information given above is incomplete or incorrect.
Date: 24/10/2018 Place: JAIPUR (Signature of the Candidate)