Wb state health & family welfare samiti recruitment 2015 technician manager vacancy application form

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WB State Health & Family Welfare Samiti Recruitment 2015 (Technician/Manager Vacancy) Application Form

APPLICATION FORMAT Self attested Photo graph

Application for the post of ………………………………………………………. 1.

Name(Capital Letter):

2. 3.

Father’s/Husband’s Name:

Address :

POST-

PIN-

4.

Date of birth:

5.

Age (as on 01.10.15):

6.

Caste :

7.

Nationality :

8.

Mobile No :

9.

Qualification (Attested photocopy of certificate must be submit with the application).

Sl No A

Educational Qualification Secondary

B

Higher Secondary

C

Graduation

D

Post Graduation

E

Others

10.

Board / University

Total Marks

Obtain Marks

Percentage of Marks (%)

Technical Qualification (Self Attested photocopy of certificate must be submit with the application):-


i) ii) iii) 11. Experience (Self Attested photocopy of experience certificate must be submit with the application):(i) (ii) (iii) DECLARATION:-I do hereby declare that all the information given above is correct and complete in all respect. I understand that my application is liable to rejection if any of the information stated above is found to be incorrect and is not supported by certificate. Place _______________________ Date

Signature of Applicant

Read Full Details About The www.wbhealth.gov.in Recruitment http://www.recruitmentinboxx.com/wb-health-recruitment2016/2713/

Read More Latest Government Jobs 2015-2016 1) AIIMS Jodhpur Recruitment 2016 Apply For 45 Junior Resident Openings http://www.recruitmentinboxx.com/aiims-jodhpur-recruitment/3370/ 2) Ordnance Factory Badmal Recruitment 2016 Medical Practitioner Walk-In http://www.recruitmentinboxx.com/ordnance-factory-badmal-recruitment/18502/


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