West Bengal Health Recruitment Board

BENFISH TOWER GN 31, Sector-V, Salt Lake, Kolkata - 700091

423459
Acknowledgement Slip for Recruitment of Tutor/Demonstrator in Physiology

Applied Post: Physiology

Advertisement No.
Registration No: 423459 R/T/D (MES)/43(1)/2017

Candidate Name: SOUMYA BHATTACHARYA

Father Name: DR T D BHATTACHARYA

Mother Name: MANIKA BHATTACHARYA

Category: UR

Date of Birth: 09/03/1989

Gender: Male

Marital Status: Unmarried

Nationality: INDIAN Medical Council: WBMC

Domicile State: West Bengal Regn. Number: 69301

Email ID: reek_sb@yahoo.co.in Physically Challenged: No

Mobile: 09804316141 Registration Date: 11/10/2017 13:30:22

Address: P 105 CIT ROAD, KOLKATA, KOLKATA, West Bengal - 700010

EDUCATIONAL QUALIFICATION:
Sr.
Exam Name Board / University / Institute Year
No.
1 MBBS Degree included in the First or Second BURDWAN MEDICAL COLLEGE 2012
Schedule or Part-II of the Third Schedule of the Indian
Medical Council Act, 1956 (102 of 1956)

2 0

Service in West Bengal Health Service & West Bengal Public Health cum Administrative Service:

NOC obtained or applied for:

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DESIRABLE DETAILS: Registration No: 423459

Sl No. Name of Article Name of Journal Publication Month & Year Volume No Publication Place

SERVICE EXPERIENCE IN RURAL AREAS:

Sl No. Capacity in Which Served Health Facility Rural Area Period From Period To
1

DECLARATION

I hereby declare that I full fill all the condition of eligibility criteria laid down in the advertisement for the post and all the statements made in the application are true,
complete and correct to the best of my knowledge and belief. In the event of may information being found false/incorrect or ineligibility being detected before or after the
written Test/Interviews, my candidature will stand automatically cancelled

Form Print Date: 05/12/2017 07:03:37 PM

LEFT THUMB IMPRESSION:

Place Signature of the candidate in running hand

Date: (*) Unsigned applications will be summarily rejected

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