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Bihar Staff Selection Commission Exam Registration

This document is a registration form for the Bihar Staff Selection Commission's Second Inter Level Combined Competitive Exam for the applicant Manish Chaurasiya. It includes personal details, educational qualifications, and a declaration of the accuracy of the provided information. The applicant is a male, 23 years old, with a background in science and has completed his 10th and 12th grades from UP Board.

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0% found this document useful (0 votes)
2 views2 pages

Bihar Staff Selection Commission Exam Registration

This document is a registration form for the Bihar Staff Selection Commission's Second Inter Level Combined Competitive Exam for the applicant Manish Chaurasiya. It includes personal details, educational qualifications, and a declaration of the accuracy of the provided information. The applicant is a male, 23 years old, with a background in science and has completed his 10th and 12th grades from UP Board.

Uploaded by

dmkd43093
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

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BIHAR STAFF SELECTION COMMISSION


P.O.-VETERINARY COLLEGE, PATNA - 800014
ADV NO.-02/23(A), SECOND INTER LEVEL COMBINED COMPETITIVE EXAM
द्वितीय इंटर स्तरीय संयुक्त प्रतियोगिता परीक्षा
PERSONAL DETAILS
REGISTRATION NO.: 2501070481
FORM NO. : 3501070481
NAME OF APPLICANT : MANISH CHAURASIYA
FATHER'S NAME : KRISHNANANAD CHAURASIYA
MOTHER'S NAME : RAJMATI
GENDER : MALE
MOBILE NO. : 7985709172
EMAIL ID : MANISHCHAURASIYA364@[Link]
DATE OF BIRTH : 15-07-2002 LIVE PHOTO

AGE AS ON 01-08-2025 : 23 YEARS, 0 MONTHS, 17 DAYS


NATIONALITY : INDIAN
CATEGORY : UR
DOMICILE OF BIHAR STATE : NO
ARE YOU PERSON WITH DISABILITY? : NO

PHOTO

SIGNATURE IN ENGLISH

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 441165356214)


ID PROOF : AADHAAR CARD ID PROOF NO : 441165356214
ARE YOU BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS
NO
REGULAR AND CONTINUOUS SERVICE? :
IN BSSC EXAMS NUMBER OF ATTEMPTS AFTER 12-12-2022:
ARE YOU A CONTRACTUAL EMPLOYEE ON ANY OF THE POSTS MENTIONED IN THE
NO
ADVERTISEMENT IN THE BIHAR GOVERNMENT? :
IDENTIFICATION MARK OF THE CANDIDATE : CUT MARK ON LEFT EYEBROW
ARE YOU AN EX-SERVICEMAN? : NO
WARD OF FREEDOM FIGHTER? : NO
HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION (UPSC/BOARD/STATE
NO
COMMISSION/ANY OTHER)? :
ARE YOU NCC FULL TIME CADET/INSTRUCTOR?: NO
ENTER NCC 'C' CERTIFICATE NO.:
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

VILLAGE MAHOKHWA POST BANSI TEHSIL VILLAGE MAHOKHWA POST BANSI TEHSIL
ADDRESS: ADDRESS:
BANSI DISTRICT SIDDHARTH NAGAR BANSI DISTRICT SIDDHARTH NAGAR

VILLAGE/MOHALLA: MAHOKHWA VILLAGE/MOHALLA: MAHOKHWA

POST OFFICE: BANSI POST OFFICE: BANSI

POLICE STATION: BANSI POLICE STATION: BANSI

DISTRICT: SIDDHARTHNAGAR DISTRICT: SIDDHARTHNAGAR

STATE: UTTAR PRADESH STATE: UTTAR PRADESH


PIN CODE: 272153 PIN CODE: 272153

EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD / TOTAL OBTAINED PERCENTAGE CERTIFICATE/ CERTIFICATE/
UNIVERSITY / MARKS/ CGPA MARKS/ CGPA MARKS MARKS
INSTITUTE SHEET SHEET ISSUE
NUMBER DATE
HINDI ENGLISH
MATHEMATICE
10TH / EQUIVALENT SCIENCE UP BOARD 600 422 70.33 73008380 09-06-2017
SOCIALSCIENCE
DRAWING
HINDI ENGLISH
12TH / EQUIVALENT
PHYSICE
12TH/INTERMEDIATE UP BOARD 500 259 51.80 7311291 27-04-2019
CHEMISTRY
(SCIENCE)
BIOLOGY
TECHNICAL SKILL
HAVE YOU DONE ANY COMPUTER COURSE? NO
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 2557254900515
TRANSACTION DATE : 2025-12-05 22:12:36
REGISTRATION FEE (RS.) : 100
DECLARATION DETAILS:

I HEREBY DECLARE THAT THE INFORMATIONS FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO DECLARE
THAT I HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND OTHERWISE, I SHALL BE LIABLE
FOR ANY LEGAL ACTION AND CANCELLATION OF MY CANDIDATURE.
DATE : 15-12-2025 22:29:57
DECLARATION ACCEPTED : YES

NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.

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