Application Form
J&K Services Selection Board
(CANDIDATES SHOULD NOT SUBMIT A PRINTOUT OF THE APPLICATION FORM TO JKSSB AT THIS STAGE.)
Name of Post JUNIOR STAFF NURSE/ JUNIOR MALE NURSE Advertisement Notice No.: 07 of 2025
RegNo 1900726627 Dated: 29-07-2025
Cadre Name DISTRICT Department Name HEALTH & MEDICAL EDUCATION DEPARTMENT
Examination Center: SRINAGAR Application No.: 2527770082866
Application Form Submission Date: 15/Sep/2025 Payment Mode/Status.: Online / Submitted
Cadre Details
[Link](99) Junior Staff Nurse / Junior male Nurse,[Link](100) Junior Staff Nurse / Junior male Nurse,[Link] (101) Junior Staff Nurse /
Junior male Nurse,[Link](102) Junior Staff Nurse / Junior male Nurse,[Link](103) Junior Staff Nurse / Junior male Nurse,[Link](104) Junior Staff Nurse /
Junior male Nurse,[Link] (105) Junior Staff Nurse / Junior male Nurse,[Link] (106) Junior Staff Nurse / Junior male Nurse,[Link](107) Junior Staff Nurse /
Junior male Nurse,[Link](108) Junior Staff Nurse / Junior male Nurse
Personal Details
Full Name: MIR SHAHIDUL ISLAM
Father’s/ Name: : GH MOHD MIR
Mother's Name ZEEBA BANO
Gender: MALE
Date of Birth: 22/01/1998 Age as on 1st January of 2025: 26 years 11 months 10 days
Mobile Number: 8825068363 LandLine Number:
Email MEERSHAHIDS143@[Link] Marital Status: UNMARRIED
Domicile No: Dom/1207/03sep2020/191315577 Domicile Date: 12-10-2020
Domicile District PULWAMA District: PULWAMA
Permanent Address
24,KOWSIBAGH ,Kakapora
Correspondence Address
24,KOWSIBAGH ,Kakapora, Pulwama
In Service
In Service(Are you an employee of J&K Government?) No
Category Details
Category: OM
Specially abled
Are you Specially abled Person: No
Experience Details
Are You Ex-Service Man: No
Have you ever been appointed for any other Government Job under J&K Government Under ESM Category No
Black List
Whether any FIR has been lodged/registered against you? No
Whether any proceeding is pending in any Court of Law against you? No
Is any case filed against you in court: No
Whether any disciplinary action has been initiated by
No
Government/Semi-Government Organisation against you?
Whether disciplinary or any other similar action is initiated by
NO
Bar Council or Medical Council or Association or other Professional/Vocational Institution?
Whether debarred or Black Listed by SSB / NO
University / SPSC / Other P.S.C/ UPSC or any other organisation?
Education Qualification
Board Marks
Exam Passed Matric Board Subject Code
Marks Type Grade CGPA Max Scored Percentage
MATRIC JKBOSE NA marks NA NA 500 217 43.40
INTERMEDIATE JKBOSE ARTS marks NA NA 500 256 51.20
GRADUATION (TECHNICAL/PROFESSIONAL) JANDK STATE PARAMEDICAL AN OTHERS marks NA NA 1300 1106 85.08
D NURSING COUNCIL
JANDK STATE PARAMEDICAL AN
OTHERS MMPHW marks NA NA 700 461 65.86
D NURSING COUNCIL
Photograph and Signature
Photograph:* Signature:*
Declaration
I Mir shahidul islam hereby declare that I have carefully read the Advertisement Notification for this post and all the terms and conditions indicated therein and undertake
to abide by the Terms and Conditions of the Advertisement / Notification for participating in the selection process, I fulfill all the terms and conditions mentioned in the
Advertisement Notification and the information provided by me herein is true and correct to the best of my knowledge. I also undertake that in case of failure to possess
the qualification prescribed in the advertisement notification, the Board will be fully competent to debar me from the selection process. I further stipulate that I have
carefully read the notification and assure that I am not barred by the provisions of the said notification. I further undertake that I shall not claim any benefit of any
qualification/category that I have not specifically indicated/uploaded in this online application [Link] uploaded document (Regarding Vertical Reservation Category viz.
SC, ST-1, ST-2, RBA, ALC/IB, Other Backward Classes(OBCs), EWS (Economically Weaker Section) shall be produced at the time of Document Verification (DV). Further, I am
aware that I will be liable for appropriate penal action, disqualification from the selection process or loss of the job in the event of selection having been made, if the
information provided by me is proved to be incorrect at any stage. The charges for filling up the form would be as mentioned in the advertisement and are non-refundable.
I am aware that I shall not have claim over the charges, once successfully paid to JAMMU AND KASHMIR Services Selection Board, JAMMU AND KASHMIR. All the disputes
related to refund of excess payment, if any, are subject matter of the Relevant Bank and JAMMU AND KASHMIR Services Selection Board.
ONLY FOR IN-SERVICE CANDIDATES
CERTIFIED THAT S/O W/O DO
SIGNATURE WITH
IS WORKING AS______________________________________________________________________________________________ STAMP OF HEAD OF
DEPARTMENT
IN
FROM
TO_____________________________________________________________________________________________________________________
ON BASIS
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