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Jr. Grade Nurse Application Form

The document is an application form for the post of Junior Grade Nurse. It contains details of the applicant such as name, date of birth, category, address, contact number, educational qualifications from 10th standard to diploma in MMPHW, date of completion of diploma, registration certificate details, documents enclosed with the application, and a declaration signed by the applicant.

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Rakesh Kumar
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9 views1 page

Jr. Grade Nurse Application Form

The document is an application form for the post of Junior Grade Nurse. It contains details of the applicant such as name, date of birth, category, address, contact number, educational qualifications from 10th standard to diploma in MMPHW, date of completion of diploma, registration certificate details, documents enclosed with the application, and a declaration signed by the applicant.

Uploaded by

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

APPLICATION FORM

1. Advertisement No.: 02/AHJ of 2002 Date: ___________


2. Post applied for: Jr. Grade Nurse
3. Name of Candidate: Jr. Grade Nurse
4. Parentage: Hem Raj
5. Date of Birth: 14-11-1997
6. Category: OBC
7. Address: Baradian, Post-Office Kharodian, Tehsil and Distt. Udhamur
8. Contact No. 9107640476
9. Details of Qualification
Examination Examining Body/Board Year of Marks Total Marks %age
Passed Passing Obtained
th
10 JKBOSE 2014 240 500 48
10+2 JKBOSE 2019 245 500 49

Marks of all semester write below mentioned columns (Technical qualification required for advt. post)
Examination Passed Examining Body/Board Year of Marks Total Marks %age
Passing Obtained
Diploma in J&K Paramedial Nursing Oct.2018 214 350
MMPHW(1stSem) Council
Diploma in J&K Paramedial Nursing May. 2019 190 350
nd
MMPHW(2 Sem) Council

[Link] 431 700 61.57


10. Date of completion of qualifying degree/diploma 09-12-2019
11. Registration Certificate: REG/JMU/MM/0936
12. Documents enclosed:
a) 10th & 12th Marks Sheet b) MMPHW Mark sheets
c) Diploma Registration Certificate d) OBC
e) Domicile f) Aadhaar Card
13. I do hereby declare that
a) The Statements made in this application are true to the best of my knowledge and belief.
b) I have never been debarred from appearing in any examination/interview.
c) I have never been arrested/prosecuted or involved in any criminal case registered by the
police or convicted by the criminal court.
d) I have undergone the degree from university head-quarters and not from the off-campuses
which have been established by these Universities beyond their territorial jurisdiction (In case of
Distance Mode).
e) I under that any wilful concealment of the facts shall results in the cancellation of my
candidature and the State Health Society may also debar me from applying for future selection.

I shall accept the selection made by the selection committee which will be binding on me.

Encls:________________
Date:
Place:
Signature of applicant
Note: The candidate needs to attach document evidence(self-attested) along with the application form,
which

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