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BIHAR STAFF SELECTION COMMISSION

P.O.-VETERINARY COLLEGE, PATNA - 800014

ADVERTISEMENT NO. 01/25

SUB STATISTICAL OFFICER/ BLOCK STATISTICAL OFFICER

PERSONAL DETAILS

REGISTRATION NO.: 1250251176

FORM NO. : 2250251176

NAME OF APPLICANT : SHIV SUNDRAM KHARWAR SHITAL

FATHER'S NAME : MURLI PRASAD KHARWAR

MOTHER'S NAME : KUNTI DEVI

GENDER : MALE

MOBILE NO. : 9717296624

EMAIL ID : SSKSHITAL744@GMAIL.COM

DATE OF BIRTH : 09-05-1992

LIVE PHOTO

AGE AS ON 01-08-2024 : 32 YEARS, 2 MONTHS, 23 DAYS

NATIONALITY : INDIAN

CATEGORY : UR

DOMICILE OF BIHAR STATE : YES

ISSUE DATE OF DOMICILE CERTIFICATE: 24-11-2023

ISSUE NUMBER OF DOMICILE CERTIFICATE : BRCCO/2023/12442653

DOMICILE CERTIFICATE ISSUING OTHER COMPETENT AUTHORITY : RO

ARE YOU PERSON WITH DISABILITY? : NO

PHOTO

SIGNATURE IN ENGLISH

SIGNATURE IN HINDI

DO YOU HAVE AADHAR CARD? : YES (AADHAR CARD NUMBER: 752930748788)

ID PROOF : AADHAAR CARD ID PROOF NO : 752930748788
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT LESS THAN 3 YEARS REGULAR AND
NO
CONTINUOUS SERVICE? :
NUMBER OF ATTEMPTS AFTER BIHAR GOVERNMENT EMPLOYEE? (AFTER DATE: 12-12-2022) : 00

IDENTIFICATION MARK OF THE CANDIDATE : A MOLE MARKS NEAR TO LEFT EAR

ARE YOU AN EX-SERVICEMAN? : NO

WARD OF FREEDOM FIGHTER? : NO

HAVE YOU EVER BEEN DEBARRED FROM ANY COMPETITIVE EXAMINATION (UPSC/BOARD/STATE
NO
COMMISSION/ANY OTHER)? :
HAVE YOU WORKED UNDER BIHAR GOVERNMENT AFTER BEING RELEASED FROM NCC AFTER JANUARY
NO
1, 1963?:
WORKED/WORKING AS CONTRACTUAL EMPLOYEE IN BIHAR GOVERNMENT: NO

ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

ADDRESS: VILL POST FAKHARABAD SARAI PS KUDRA ADDRESS: VILL POST FAKHARABAD SARAI PS KUDRA
VILLAGE/MOHALLA: FAKHARABAD SARAI VILLAGE/MOHALLA: FAKHARABAD SARAI
POST OFFICE: FAKHARABAD POST OFFICE: FAKHARABAD
POLICE STATION: KUDRA POLICE STATION: KUDRA
DISTRICT: KAIMUR DISTRICT: KAIMUR
STATE: BIHAR STATE: BIHAR
PIN CODE: 821108 PIN CODE: 821108
EDUCATIONAL QUALIFICATIONS

EDUCATION SUBJECT BOARD / UNIVERSITY / TOTAL MARKS MARKS OBTAINED PERCENTAGE PASSINGDATE CERTIFICATE
INSTITUTE NUMBER
 MATHS HINDI

10TH / SANSKRIT SCIENCE

B S E B PATNA 500 296 59.20 15-07-2008 76-0357722
EQUIVALENT ENGLISH SOCIAL

SCIENCE

MATHS PHYSICS
12TH / CHEMISTRY ENGLISH B S E B PATNA 500 300 60.00 04-06-2010 S028359
EQUIVALENT HINDI

MATHEMATICS VENKATESHWARA
GRADUATION ELECTRONICS AND INSTITUTE OF
OTHER (B 5000 3469 69.38 21-01-2016 BTECH/2015031548
COMMUNICATION TECHNOLOGY
TECH)
ENGINEERING MEERUT UP

DO YOU HAVE WORK EXPERIENCE? NO

EXPERIENCE CERTIFICATE NO.? EXPERIENCE CERTIFICATE ISSUE DATE?
ORGANISATION DESIGNATION/POSITION PERIOD FROM PERIOD TO
PAYMENT DETAILS:

PAYMENT BANK : SBI

TRANSACTION ID : 4749469593419

TRANSACTION DATE : 2025-04-19 20:57:21

REGISTRATION FEE (RS.) : 540

DECLARATION DETAILS:

I HEREBY DECLARE THAT THE INFORMATIONS FILLED UP ABOVE BY ME ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I ALSO DECLARE THAT I

HAVE FILLED UP ONLY ONE APPLICATION FORM. I ALSO UNDERTAKE THAT IF ANY INFORMATION IS FOUND OTHERWISE, I SHALL BE LIABLE FOR ANY LEGAL

ACTION AND CANCELLATION OF MY CANDIDATURE.

DATE : 19-04-2025 22:37:56

DECLARATION ACCEPTED : YES

NOTE: PLEASE KEEP YOUR REGISTRATION NO.,PASSWORD,MOBILE NO AND EMAIL-ID CAREFULLY FOR FURTHER REFERENCE.