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Registration Slip 6250726108

The document is an application form for the Bihar Staff Selection Commission's Office Attendant/Attendant (Special) Combined Competitive Exam, submitted by Javed Alam. It includes personal details such as registration number, age, nationality, caste, educational qualifications, and payment information. The applicant declares the information provided is true and correct, and acknowledges the importance of keeping registration details for future reference.
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0% found this document useful (0 votes)
30 views2 pages

Registration Slip 6250726108

The document is an application form for the Bihar Staff Selection Commission's Office Attendant/Attendant (Special) Combined Competitive Exam, submitted by Javed Alam. It includes personal details such as registration number, age, nationality, caste, educational qualifications, and payment information. The applicant declares the information provided is true and correct, and acknowledges the importance of keeping registration details for future reference.
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.-06/25
OFFICE ATTENDANT/ATTENDANT(SPECIAL) COMBINED COMPETITIVE EXAM
कार्यालय परिचरी/परिचरी (विशेष) संयुक्त प्रतियोगी परीक्षा
PERSONAL DETAILS
REGISTRATION NO.: 6250726108
FORM NO. : 7250726108
NAME OF APPLICANT : JAVED ALAM
FATHER'S NAME : KHURSHID ALAM
MOTHER'S NAME : SABRA KHATUN
GENDER : MALE
MOBILE NO. : 8578982508
EMAIL ID : [email protected]
DATE OF BIRTH : 02-01-2000 LIVE PHOTO

AGE AS ON 01-08-2025 : 25 YEARS, 6 MONTHS, 30 DAYS


NATIONALITY : INDIAN
CATEGORY : EBC
DO YOU BELONG TO NON-CREAMY LAYER ? : YES
CASTE : DHOBI (MUSLIM) / धोबी (मुस्लिम)
(EBC/BC-NCLC CERTIFICATE NUMBER) / (SC/ST-CASTE CERTIFICATE
710080
NUMBER) / (EWS-CERTIFICATE NUMBER) :
ISSUE DATE OF CERTIFICATE : 02-09-2022
CERTIFICATE ISSUING AUTHORITY : RO
PHOTO
DOMICILE OF BIHAR STATE : YES
ISSUE DATE OF DOMICILE CERTIFICATE: 20-12-2024
ISSUE NUMBER OF DOMICILE CERTIFICATE : 15698863
DOMICILE CERTIFICATE ISSUING COMPETENT AUTHORITY : RO
SIGNATURE IN ENGLISH
ARE YOU PERSON WITH DISABILITY? : NO

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 897002435572)


ID PROOF : AADHAAR CARD ID PROOF NO : 897002435572
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS REGULAR AND
NO
CONTINUOUS SERVICE? :
NUMBER OF ATTEMPTS AFTER BIHAR GOVERNMENT EMPLOYEE?
01
(AFTER DATE: 12-12-2022) :
CUT MARK ON LEFT HAND MIDDLE
IDENTIFICATION MARK OF THE CANDIDATE :
FINGER
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)? :
HAVE YOU WORKED UNDER BIHAR GOVERNMENT AFTER BEING RELEASED FROM NCC AFTER
NO
JANUARY 1, 1963?:
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

PATPARIYA MOTIHARI EAST CHAMPARAN PATPARIYA MOTIHARI EAST CHAMPARAN


ADDRESS: ADDRESS:
BIHAR 845401 BIHAR 845401
VILLAGE/MOHALLA: PATPARIYA VILLAGE/MOHALLA: PATPARIYA

POST OFFICE: RUPDHI POST OFFICE: RUPDHI


POLICE STATION: MUFFASIAL MOTIHARI POLICE STATION: MUFFASIAL MOTIHARI
DISTRICT: EAST CHAMPARAN DISTRICT: EAST CHAMPARAN

STATE: BIHAR STATE: BIHAR


PIN CODE: 845401 PIN CODE: 845401
EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD / TOTAL MARKS MARKS OBTAINED PERCENTAGE PASSINGDATE CERTIFICATE
UNIVERSITY NUMBER
10TH / MATHS SANSKRIT BSEB 500 263 52.60 05-06-2014 0552376
EQUIVALENT HINDI SOCIAL
SCIENCE SCIENCE
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 6230990575615
TRANSACTION DATE : 2025-09-13 09:51:23
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 : 15-09-2025 19:48:16
DECLARATION ACCEPTED : YES

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

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