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X-1 Form
Personal Details Candidate Belongs to - CG
Registration Registered
Registration No. CT15120195212 1 Jul 2019 SELF
Date By
Renewal Date 31 Jul 2022 Renewed by
1. Name ANURAG     MANDAL

2. Father's Name BIDHAN

3. Mother's Name CHANDRA

4. Date of Birth 30 Jun 1996

5. Place of Birth NA

6. Sex Male 7. Urban/Rural Urban

8. Marital Status Unmarried

9. Email MANDAL
10. Phone Number 7587002098
11. Caste General

12. Religion Hinduism

13. Language Details

Language Known Proficiency
BENGALI Speak only
ENGLISH Read and Write and Speak
HINDI Read and Write and Speak

Disability (More than 40%) No Disability

Blood Group B Plus

15. Address WARD NO. 9, HOUSE NO. 3

RES colony road, shriram nagar, near
bhairav Baba
kanker
Kanker
Chhatisgarh
Pincode - 494334

16. Qualification Details

Passing Medium of Verified
Exam passed Board/University Division School/Institute Percentage Subjects
Year Instruction By
Board of
ENGLISH ,HINDI
Secondary
,MATHS ,SOCIAL
10th/Matric Pass Education Second 2011 MDAV SCHOOL ENGLISH 52.83% N
SCIENCE ,SANSKRIT
Chhattisgarh,
,SCIENCE ,
Raipur
Board of
Secondary CHEMISTRY
12th/Intermediate
Education First 2014 MDAV SCHOOL ENGLISH 61.80% ,ENGLISH ,HINDI N
Science
Chhattisgarh, ,MATHS ,PHYSICS ,
Raipur
Board of
GOVERMENT
Secondary
ENGINEERING MINING
B.E. Education First 2018 ENGLISH 68.88% N
COLLEGE, ENGINEERING ,
Chhattisgarh,
JAGDALPUR
Raipur
8th/Middle Pass Board of First 2009 MDAV SCHOOL ENGLISH 78.40% ENGLISH ,HINDI N
 Secondary ,MATHS ,SOCIAL
Education SCIENCE ,SANSKRIT
Chhattisgarh, ,SCIENCE ,
Raipur
Board of
Secondary ENGLISH
5th Class Pass Education Second 2006 MDAV SCHOOL ENGLISH 49.33% ,ENVIRONMENT N
Chhattisgarh, ,HINDI ,MATHS ,
Raipur

17. NCO Details

Not Available

18. Exclude NCO Details

Not Available

19. Trade

22. Experience Details

Name of Nature-of- Pay on
Post/Designation From To NCO Type of Job
Employer Work Leaving(Rs./month)
ANURAG 23 Jul
TRAINEE 8 Jun 2013 Full Time 0
MANDAL 2016
ANURAG 30 Jul
TRAINEE 1 Jul 2017 Full Time 0
MANDAL 2017

24. Are you currently self employed No 25. If yes, specify

31. Are you interested in Self Employment 32. If So, Desired Self-Employment

37. Non Availability Duration

From To
40.Remarks  
All the above information is based on my inputs and is true to the best of my knowledge. If any information furnished by me
turns out to be false subsequely,my registation may be cancelled.

Signature

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