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Application Form For NRHM Recruitment 2016 (45 Consultant/Asst
& Other Vacancy)
Recent passport size
self attested
photograph of
candidate
PERSONAL INFORMATION
1. Name ( IN CAPITAL LETTERS): __________________________________
(Please underline surname)
2. Father’s Name : ______________________________________________
3. Date of Birth: _____________________________(attach proof)
Age as on 15
st
October, 2015:____________________________________________
4. I am a (tick one):
Indian Citizen with valid Himachal domicile Indian Citizen without valid Himachal
domicile
others
5.Sex: Male Female
6.Marital Status : Married Single
7.Permanent Address : Vill____________ PO____________ Tehsil ____________
Distt. ___________________________
8. Address for Correspondence:
___________________________________________________________
_______________________________________ Postal Code: ________________
Contact No (Mobile): __________________ Email address: ____________________
9. ACADEMIC QUALIFICATIONS (Matric and above)
Date Schools/Institutions Affiliation/ Qualificatio Percentage
RecognitionAttended ns Obtained (aggregate)/Grade
From To
10. OTHER QUALIFICATIONS /
COURSES ATTENDED /
AWARDS ATTAINED
(including
computer literacy)
Date
From To
11. EXPERIENCE
Sr,No. Name of Organization From To Total
12.Name & Registration No.of employment exchange
13.Detail of Fee in favour of the MD, NHM,HP payable at Shimla-9
i) Rs.200/- in case of UR candidate
ii) Rs.100/- in case of SC/OBC/IRDP
DD No./Date Dated Rs. Drawn on
14. LIST OF ENCLOSURESSelf attested copies of
1. Matric certificate
2. Copies of related course/Degree required for the post.
3. Experience
4. Latest category certificate of SC/ OBC {only for those posts reserved for these
category}
5. Self addressed two envelope size 6”x11” duly stamped with Rs 5/-
15. Verification
NRHM Recruitment 2016 Full Details
http://recruitmentresult.com/nrhm-recruitment/
Awarding InstitutionQualifications / Awards Obtained

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Application Form for NRHM Recruitment 2016 (45 Consultant-Asst & Other Vacancy)

  • 1. Application Form For NRHM Recruitment 2016 (45 Consultant/Asst & Other Vacancy) Recent passport size self attested photograph of candidate PERSONAL INFORMATION 1. Name ( IN CAPITAL LETTERS): __________________________________ (Please underline surname) 2. Father’s Name : ______________________________________________ 3. Date of Birth: _____________________________(attach proof) Age as on 15 st October, 2015:____________________________________________ 4. I am a (tick one): Indian Citizen with valid Himachal domicile Indian Citizen without valid Himachal domicile others 5.Sex: Male Female 6.Marital Status : Married Single 7.Permanent Address : Vill____________ PO____________ Tehsil ____________ Distt. ___________________________ 8. Address for Correspondence: ___________________________________________________________ _______________________________________ Postal Code: ________________ Contact No (Mobile): __________________ Email address: ____________________ 9. ACADEMIC QUALIFICATIONS (Matric and above) Date Schools/Institutions Affiliation/ Qualificatio Percentage RecognitionAttended ns Obtained (aggregate)/Grade From To
  • 2. 10. OTHER QUALIFICATIONS / COURSES ATTENDED / AWARDS ATTAINED (including computer literacy) Date From To 11. EXPERIENCE Sr,No. Name of Organization From To Total 12.Name & Registration No.of employment exchange 13.Detail of Fee in favour of the MD, NHM,HP payable at Shimla-9 i) Rs.200/- in case of UR candidate ii) Rs.100/- in case of SC/OBC/IRDP DD No./Date Dated Rs. Drawn on 14. LIST OF ENCLOSURESSelf attested copies of 1. Matric certificate 2. Copies of related course/Degree required for the post. 3. Experience 4. Latest category certificate of SC/ OBC {only for those posts reserved for these category} 5. Self addressed two envelope size 6”x11” duly stamped with Rs 5/- 15. Verification NRHM Recruitment 2016 Full Details http://recruitmentresult.com/nrhm-recruitment/ Awarding InstitutionQualifications / Awards Obtained