Candidate Basic Registration

BLOCK HEALTH MITRA

Advertisement Number:

01/2023 (01/08 Batch)

Applied For:

BLOCK HEALTH MITRA

Advertisement Name:

Institute of Health & Child Education offered Health Supervisor /Coordinator , Block Health Mitra, Sahayak Block Health Mitra

Date for Calculating Age

31-03-2023

Type of Admission

Direct

Duration:

1.5 YEAR

Candidate's Personal Information

Candidate's Name (Max. 35 Chars. )

Mother's Name (Max. 35 Chars. )

Father's/Husband's Name (Max. 35 Chars. )

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Date Of Birth (DD/MM/YYYY)

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Nationality

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High School , Intermediate Board, , Year of passing & Roll Number Details * ↓

Sr. No	Examination Passed	Board Name/ Institute/ University	Year of Passing	Roll Number	Is Grade System	Obtained Marks/CGPA	Total Marks	Percentage
1	High School							Converted percentage value required
2	Intermediate							Converted percentage value required

Declaration:- I hereby declare that I have submitted only one application form and all the above informations are correct & true to the best of my knowledge and belief. In case of any discrepancy you are entitled to cancel my admission at any time.

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