Staff Selection Commission

(Block No. 12, CGO-Complex, Lodhi Road, New Delhi

110003 )
Selection Post Examination Phase-VI, 2018
Registration No: 61001495170

Application Status: Application provisionally submitted

Preference of examination center Region for Posts Post Category Number Post Name
& Document verification center
Kolkata NR NR12318 Canteen Attendant
Name Father Name Mother Name Date of Birth
KHUSHBOO KUMARI ASHOK PRASAD CHANDA DEVI 1998-02-02
Gender Nationality Category
Female Indian OBC
Whether ex-serviceman Length of Service Date of Discharge If ExS, whether eligible for
reservation ?
No
Seeking Age Relaxation? Age Relaxation code Whether Person with If yes,type of Age as on 01/08/2018
Disability? disability(OH,HH,VH,Othe
rs)
No No 20.6
Do you suffer from Cerebal Do you suffer from Locomotor Whether scribe is required in case If scribe is required, then indicate
Palsy(40% or more)? Disability (40% or more) wherein of VH/Cerebral Palsy/Locomotor medium
the dominant writing extremity is Disability (40% or More)?
affected to the extent of slowing
down the performance?
No No No
Fee Amount Transaction-ID Transaction Date
Fee Exempted

Do you want to make available your personal information for accessing job opportunity in terms of Dop&T's O.M.
No.39020/1/2016-Estt.(B) dated 21.06.2016 ?
Yes

Educational Qualification
Course Subject Percentage of marks Medium
MATRICULATION FROM A ANY SUBJECT 61.20 Hindi
RECOGNIZED BOARD OR
EQUIVALENT.

Details of Work Experience / Govt. Service rendered)

Name of Organization(s) Designation Nature of Duty(ies) Period of Service
-
-
-

Address Detail
Communication Address Permanent Address
D/O- ASHOK PRASAD VILL- VISHWANATHPUR FARDAHA D/O- ASHOK PRASAD VILL- VISHWANATHPUR FARDAHA
P.O- FARDAHA P.S- BAHERA P/O- FARDAHA P/S- BAHERA
DARBHANGA , DARBHANGA District:
BIHAR,847233 State: Bihar
Pin Code: 847233

Declaration
I hereby declare that all statements made in this application are true, complete and correct to the best of my knowledge
and belief. I understand that in the event of any information being found suppressed/false or incorrect or ineligibility
being detected before or after the examination, my candidature/appointment is liable to be cancelled

Printed on:(mm/dd/yyyy): 10/04/2018 05:19:17