Application Form for NRHM Tripura Recruitment 2016 Various Posts Notification

1. Application Form For NRHM Tripura Recruitment 2016 Various Posts Notification FORMAT To The Executive Secretary District Health & Family Welfare Society O/o the Chief Medical Officer, North Dharmanagar, North, Tripura. 1)Name of the post applied for 2)Name of the Candidate 3)Fathers/Husband name 4)Permanent address with pin code 5)Postal address for communication with pin code 6)Date of Birth (attach proof) 7)Nationality (Attach proof- PRCT/EPIC/Citizenship Certificate) 8)Sex (Male/Female) 9) Whether ST/SC/UR (If belongs to SC/ST community attach certificate) : 10) Contact Number & Email ID (if any) : 11) Educational Qualification (Attach photocopy of all relevant mark sheet) 12)Technical Qualification (if any, attach supporting documents) 13)Experience (if any, attach supporting documents) Affix a recent passport size colored photograph with full signature on it (Do not staple) : (IN BLOCK LETTERS) : (IN BLOCK LETTERS) : : (Attach address proof certificate) : : : : Sl. No. Name of the examination Name of the recognized University/Board/ Institution Year of passing Percentage of marks obtained :: DECLARATION BY THE CANDIDATE I Sri / Smt. / Dr. …………………………………………………………………………………………………. Son/Daughter/Wife of…………………………….. …………………………………………………………… hereby declare that, all the information given above is true to the best of my knowledge, if any of the above information is found to be incorrect at later stage, I shall be liable to be disqualified and removed from the service after selection/joining. Date: Place: (Signature of the candidate in full) Copy to: The Editor Daily Desher Katha / Dainik Sambad / Syandan Patrika to publish this advertisement (Notice for Recruitment) in their esteemed daily on 23/09/2015. NRHM Tripura Recruitment 2016 Full Details http://recruitmentresult.com/nrhm-tripura-recruitment/