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Proforma to be filled in by applicants applying for the post of Specialist Doctor/ Contract Medical Practitioners/Nursing Sisters/Pharmacist/Hospital Attendants
Notice No. Sr.DPO/SC Notification No.03/2020/Para-Medical, dt. 20.08.2020
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Specialist Doctor
Contract Medical Practitioners
Nursing Sisters
Pharmacist
Hospital Attendents
Name
Your answer
Father's/Husband's name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age as on closing date
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Community
SC
ST
OBC
UR
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Postal Address
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Phone/Mobile number
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Nearest Railway station
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E-Mail ID
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Are you ex Railway employee
YES
No
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If you are a ex Railway employee, give details
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Nationality
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Highest Educational qualification secured
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MS/MD
MBBS
BSc(Nursing)
Diploma in Nursing
D Pharma
M Pharm
B Pharm
Pharma D
Intermediate
SSC
ITI
For the Education Qualification mentioned above, mention year of passing
Your answer
For the Education Qualification mentioned above, aggregate percentage of marks secured
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Details of Experience, if any
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