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Pharmaceuticals & Medical Devices Bureau of India (Pmbi) : Father's Name Mother's Name

The document is an application form for a post at the Pharmaceuticals & Medical Devices Bureau of India (PMBI). It requires personal details, educational qualifications, work experience, and references from the applicant. The applicant must certify the accuracy of the information provided and acknowledge the consequences of any false information.

Uploaded by

NITESH KUMAR
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4 views2 pages

Pharmaceuticals & Medical Devices Bureau of India (Pmbi) : Father's Name Mother's Name

The document is an application form for a post at the Pharmaceuticals & Medical Devices Bureau of India (PMBI). It requires personal details, educational qualifications, work experience, and references from the applicant. The applicant must certify the accuracy of the information provided and acknowledge the consequences of any false information.

Uploaded by

NITESH KUMAR
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

PHARMACEUTICALS & MEDICAL DEVICES BUREAU OF INDIA (PMBI)

(Set up under the aegis of Department of Pharmaceuticals, Govt. of India)


B-500, Tower B, 5th Floor, World Trade Centre, Nauroji Nagar,
New Delhi – 110029

Application for the Post of______________________________________________

1. Name of the Candidate :


Recent
2. Sex (Male/Female/Others) :
Photo
3. Father’s Name :

4. Mother’s Name :

5. Age & Date of Birth :

6. Permanent Residential Address :

7. Present Mailing Address :

8. Contact No. & Email Id :

9. Nationality :

10. Marital Status :

11. Aadhar no./Pan No. : /

12. Languages Known :


Speak :
Write :

13. Educational Qualification (Starting from matriculation onwards):


S. Course/Certificate/ Board/University Year of Subjects %age of
No. Diploma/Degree Passing (Main) Marks

Page 17 of 18
14. Work Experience (Starting from latest organization):
Type
Period
of Total salary
S. organiz Period drawn per
Name of the Post
No ation Job responsibilities month
organization held in
. (Govt. From To
years &
/PSU/
Pvt.) months

15. Total Post Qualification Experience in Applied Post Profile (In Years) :
16. Total Experience in Govt. Sector (If any) (In Years) :
17. Split up details of latest drawn salary :
18. Any two references (One from latest organization is must) :
19. Any other relevant information :
20. I, ___________________S/o/D/o of Shri/Smt.__________________Certified that the above
information is true and correct, and I shall provide originals as and when the Management
desires. In case of any information furnished above is proved to be incorrect, I am liable to
be terminated without any notice and suitable legal action shall be taken.

(Signature of the applicant)

Date:

Place:

Page 18 of 18

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