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  • Online Application Form Contractual Staff Nurse-Urban Health and Wellness Center (SN-UHWC-NHMMP) Under NHM, M.P

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    This document is an online application form for the position of Contractual Staff Nurse-Urban Health and Wellness Center (SN-UHWC-NHMMP) under NHM, M.P. The applicant, Suman Sahu, provides personal details like name, father's name, date of birth, contact information, category, marital status, domicile and examination center preferences. Educational qualifications of 10th, 12th and GNM courses are also listed, along with a declaration that the information provided is true to the best of the applicant's knowledge.

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    This document is an online application form for the position of Contractual Staff Nurse-Urban Health and Wellness Center (SN-UHWC-NHMMP) under NHM, M.P. The applicant, Suman Sahu, provides personal details like name, father's name, date of birth, contact information, category, marital status, domicile and examination center preferences. Educational qualifications of 10th, 12th and GNM courses are also listed, along with a declaration that the information provided is true to the best of the applicant's knowledge.

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    40 views1 page

    Online Application Form Contractual Staff Nurse-Urban Health and Wellness Center (SN-UHWC-NHMMP) Under NHM, M.P

    Uploaded by

    yogesh pandey
    This document is an online application form for the position of Contractual Staff Nurse-Urban Health and Wellness Center (SN-UHWC-NHMMP) under NHM, M.P. The applicant, Suman Sahu, provides personal details like name, father's name, date of birth, contact information, category, marital status, domicile and examination center preferences. Educational qualifications of 10th, 12th and GNM courses are also listed, along with a declaration that the information provided is true to the best of the applicant's knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    ONLINE APPLICATION FORM

    Contractual Staff Nurse-Urban Health and Wellness Center (SN-UHWC-NHMMP) under


    NHM, M.P.

    Application No.: आवेदन संख्या : 208127 Position Code/ पद कोड : SN-UHWC-NHMMP

    1. Personal Details: व्यक्तिगत विवरण:


    Candidate's Name:
    Suman Sahu Father's/ Husband's Name:
    pravesh kumar sahu Photograph:
    आवेदक का नाम पिता / पति का नाम

    Gender: लिंग: FEMALE Date of Birth (DD/MM/YY): जन्मतिथि 01-Feb-1996

    Mobile Number: मोबाइल नंबर : 8639398962 Alternate Number: दूरभाष संख्या :

    Email ID: ईमेल आईडी : pradeepcomputer2014@gmail.com Category: (वर्ग): OBC

    Marital Status (वैवाहिक स्थिति) * Married Current Base Station District and State
    Rewa (MP)
    (वर्तमान जिला और राज्य *)

    Domicile Details: अधिवास विवरण: Rewa, Madhya Pradesh

    Examination Center/ City Preference: 1. Rewa 2. Jabalpur 3. Bhopal 4. Gwalior 5. Indore 6. Ujjain 7. Sagar

    Do you have any criminal case under consideration in the court or have you ever been punished No
    by the court. (क्या आपका कोई आपराधिक मामला न्यायालय में विचाराधीन है या आपको कभी न्यायालय द्वारा दंडित
    किया गया है)?

    Do you have more than one living husband*: (क्या आपके एक से अधिक जीवित पति हैं)? No

    Do you have a third living child who was born after 26 January 2001*:
    No
    (क्या आपका कोई तीसरा जीवित बच्चा है जिसका जन्म 26 जनवरी 2001 के बाद हुआ है)?

    2. Address: पता
    Correspondence/ Current Address with Pin Code: Permanent Address with Pin Code:

    gram pakra post barahata teh mauganj dist rewa mp


    gram pakra post barahata teh mauganj dist rewa mp

    486331 486331

    3. Educational Qualification Details: शैक्षिक योग्यता विवरण:


    Course Specialization/ Subject Name of University/ Institute Mode Of Course Marks% Course Duration

    10th ALL SUBJECT govt high school khaira kan kesara Full Time 57.5
    ( Percentage: 02-Jun-10 to 28-May-11

    rewa 57.5)

    12th PCB GOVT PUSHPRAJ H S SCHOOL Full Time 58


    ( Percentage: 06-Jun-12 to 21-May-13

    KHUTHA REWA 58)

    GNM GNM LATE ML CHAURASIYA MEMORIAL Full Time 74.75


    ( Percentage: 14-Jul-14 to 15-Apr-18

    NURSING SCHOOL CHAURASIYA 74.75)


    HOSPITAL AND RESEARCH REWA

    Do you have 89 days of working experience in the Government Health Institutions/ NHM as a Staff Nurse in the COVID Programme? No

    Declaration by Candidate: I hereby declare that the information furnished above is true to the best of my knowledge and any misrepresentation, falsification or omission of
    information used to secure employment shall be grounds for rejection of this application and I would liable for legal action, also immediate discharge if I am employed by NHM,
    M.P. regardless of the time elapsed before discovery.

    घोषणा: मेरे द्व़ारा ये घोषित किया जाता है कि उपर्युक्त दी गई सूचना मेरी जानकारी के अनुसार सही है रोजगार पाने के लिए कि गई अगर किसी भी गलत बयानी, मिथ्याकरण या जानकारी कि चूक के कारण
    इस आवेदन की अस्वीकृ ति के लिए पात्र हूं और कानूनी कार्रवाई के लिए जिम्मेदार हूं और किसी भी समय मुझे तत्काल पद से बर्खास्त किया जाए अगर मै NHM, M.P. में कार्यरत हूं ।

    Date: 26-May-2022

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