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SSC CHSL PDF

This document is an application for the Combined Higher Secondary Level Examination submitted by Arunima Saha. It provides her personal details such as name, father's name, date of birth, gender, nationality, category, address, and contact information. It also includes the examination center code she has selected, details about fee payment, educational qualifications, and a declaration that the information provided is true.

Uploaded by

Anindam Saha
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147 views

SSC CHSL PDF

This document is an application for the Combined Higher Secondary Level Examination submitted by Arunima Saha. It provides her personal details such as name, father's name, date of birth, gender, nationality, category, address, and contact information. It also includes the examination center code she has selected, details about fee payment, educational qualifications, and a declaration that the information provided is true.

Uploaded by

Anindam Saha
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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Staff Selection Commission

Block No. 12, CGO-Complex, Lodhi Road, New Delhi 110003


COMBINED HIGHER SECONDARY LEVEL (10+2)
EXAMINATION-2017
Registration No: 64012925816

Application Status: Application provisionally submitted

Name of the Examination Centre Examination Centre Code


ER-Kolkata(4410) 4410
ER-Barasat(4402) 4402
ER-Chinsurah(4405) 4405
Candidate's Full Name Father's Name Mother's Name
ARUNIMA SAHA ANUP KUMAR SAHA ARATI SAHA
Date of Birth Gender
1995-09-17 Female
Nationality Fee Category
Indian Exemption claimed SC
If Ex-serviceman Length of Service Date of Discharge If, ExS, Whether eligilble for
reservation?
No
Whether PH? If yes,indicate code If Cerebral Palsy? Do you suffer from If VH/Cerebral Palsy/ If yes, indicate
Locomotor Disability Locomotor whether medium
(40% or more) scribe is required?
wherein the dominant
writing extremity is
affected to the extent
of slowing down the
performance?
No
Indicate Age relaxation code Age as on 01.08.2018 Indicate medium for Typing Test Do you possess educational
qualification of 12th standard pass
in Science stream with
Mathematics as a subject from a
recognised Board or equivalent
(for DEO in C&AG)?
22.10 English No
Mark of visible identification Whether belong to Minority Communities?
No
Mode of Fee Payment Amount Transaction-ID Transaction Date

Educational Qualification (Please note that possession of Intermediate/Higher Secondary/12th Standard Qualification is
a pre-requisite to apply for this examination,However you may indicate your highest qualification)
B.Com.(Hons.)

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

Address Details
Communication Address Permanent Address
11/2A SIR GURUDAS ROAD 11/2A SIR GURUDAS ROAD KOLKATA
City: KOLKATA State: West Bengal
District: KOLKATA Pin Code: 700054
State: West Bengal Mobile No.: 8013592407
Pin Code: 700054 Email Id: riyasaha.angels@gmail.com

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)12/12/2017 23:15:39

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