125130390575

Common Candidate Details

1 2 4 5 6 7

Salutation FullName Gender DateofBirth PlaceofBirth MaritalStatus

Single/Unmar
Male/Female DD/MM/YYY ried
Mr/Ms/Mrs/ * /Transgender * Married
Mx * Y*
* Divorcee
Widow *

Mr AJAY KUMAR Male 07/05/2001 Lakhimpur Single

Mr AKHILESH KUMAR Male 05/06/1998 Lakhimpur Married
Mr ALOK KUMAR VERMA Male 07/06/1994 Lakhimpur Single
Mr AMIT KUMAR Male 30/06/2000 Lakhimpur Single
Mr AMRENDRA KUMAR SHUKLA Male 08/01/2003 Lakhimpur Single
Ms ANEETA PAL Female 04/09/1999 Lakhimpur Single
Ms ANUPAM DEVI Female 07/10/1998 Lakhimpur Single
Mr KAMALJEET SINGH Male 02/12/1995 Lakhimpur Single
Mr LAVKUSH KUMAR Male 20/05/2000 Lakhimpur Single
Ms LAXMI DEVI Female 15/07/1995 Lakhimpur Single
Mr MALIK RAM Male 20/02/1998 Lakhimpur Single
Mr MANOJ KUMAR Male 02/05/2000 Lakhimpur Single
Mr NEERAJ Kumar Mourya Male 08/07/1995 Lakhimpur Single
Mr NIRMAL KUMAR Male 15/08/1992 Lakhimpur Married
Mr OM PRAKASH SHUKLA Male 30/06/1989 Lakhimpur Married
Mr PANKAJ KUMAR Male 02/10/2002 Lakhimpur Single
Mr PRADEEP DAS Male 08/10/1992 Lakhimpur Married
Mr PRASANG VERMA Male 06/07/2001 Lakhimpur Single
Mr RAJENDRA KUMAR Male 07/09/1993 Lakhimpur Married
Mr SANDEEP KUMAR PAL Male 08/10/1993 Lakhimpur Single
Ms SANGEETA DEVI Female 05/05/2002 Lakhimpur Single
Mr SEVAK RAM Male 07/05/2000 Lakhimpur Single
Mr SHYAM JI SHUKLA Male 02/12/1998 Lakhimpur Single
Mr SUNIL SINGH Male 01/01/1992 Lakhimpur Married
Mr SUNIL KUMAR VERMA Male 20/07/1990 Lakhimpur Married
Mr VINEET JAISWAL Male 03/02/1998 Lakhimpur Single
Mr YOGESH KUMAR DIXIT Male 01/01/1989 Lakhimpur Married

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 125130390575

8 9 10 14 15

FathersName MotherMaidenName GuardianName Category DisabilityT

ype

General/S
* * * C/ST/OBC* Yes/No*

CHANDAN LAL SUSHILA DEVI CHANDAN LAL OBC No

JAG PRATAP SHOBHA DEVI JAG PRATAP OBC No
BUDHESH KUMAR MAYA DEVI BUDHESH KUMAR OBC No
SATISH KUMAR URMILA DEVI SATISH KUMAR OBC No
BRIJENRA KUMAR SHUKLA SUMAN SHUKLA BRIJENRA KUMAR SHUKLA OBC No
RAM NAHT PAL RAM SAGRI RAM NAHT PAL OBC No
UMESH KUMAR GUDDI DEVI UMESH KUMAR OBC No
IKBAL SINGH RANJEET KAUR IKBAL SINGH General No
MANOHAR LAL SHAIL KUMARI MANOHAR LAL OBC No
VIDYA PRAKASH MAYA DEVI VIDYA PRAKASH OBC No
RAM NATH PAL RAM SAGRI RAM NATH PAL OBC No
ITWARI LAL VIDHA DEVI ITWARI LAL OBC No
TRIVENI PRASAD MOURYA KAMLESHA DEVI TRIVENI PRASAD MOURYA OBC No
RAM KUMAR MAYA DEVI RAM KUMAR OBC No
KISHORI LAL SHUKLA KRISHNA DEVI KISHORI LAL SHUKLA OBC No
TEERATH RAM SAVITRI DEVI TEERATH RAM OBC No
SOHAN DAS SAVITA DEVI SOHAN DAS OBC No
ajay verma sangeeta verma ajay verma OBC No
PARMESHWAR DAYAL SUNITA DEVI PARMESHWAR DAYAL OBC No
INDRA BAHADUR BASANTI INDRA BAHADUR OBC No
LALLU RAM MAYA DEVI LALLU RAM OBC No
MANOHAR LAL SAVITRI DEVI MANOHAR LAL OBC No
SATYA PRAKASH SHUKLA KIRTI SHUKLA SATYA PRAKASH SHUKLA OBC No
VIJAY SINGH RACHLI DEVI VIJAY SINGH OBC No
RAM NARESH VERMA SHNTI DEVI VERMA RAM NARESH VERMA OBC No
RAM VRIKSH UMA DEVI RAM VRIKSH OBC No
PUTTI LAL DIXIT PHOOL MATI PUTTI LAL DIXIT OBC No

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 125130390575

16 17 18 19 20 21 22 23

PermanentAd ParliamentCo
Religion City District State PinCode Country
dress nstituency

Hindu/Musli
m/Christian/ 6 Digit
Atheist/Budd * * * * * *
Number*
hist/Sikh/Jew
s/Other*

Hindu VILL AND P Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL MOHANLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu UPSDM100@Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL INDRA Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL GAURIYLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL AND POLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL AND P Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILLMAKHANLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL BELWA Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL AND POLakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL AND POLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL AND P Lakhimpur Lakhimpur Uttar Pradesh 262905 Lakhimpur India
Hindu VILL CHAND Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL AND POLakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL LAKHA Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL BOJHIYLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL BANGA Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu moh. tharvaraLakhimpur Lakhimpur Uttar Pradesh 262701 Lakhimpur India
Hindu VILL LONIY Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu MAJHRIYA P Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL CHAND Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL SOHAR Lakhimpur Lakhimpur Uttar Pradesh 262724 Lakhimpur India
Hindu VILL GAURIYLakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL NAREN Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL AND P Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL AND P Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India
Hindu VILL BELWA Lakhimpur Lakhimpur Uttar Pradesh 262907 Lakhimpur India

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 125130390575

24 25 26 28 27 29 30 31

CurrentParlia CurrentCount CandidateMo

CurrentAddre CurrentCity CurrentDistric CurrentState CurrentPinCo mentConstitu
ss t de ry bileNo
ency

6 Digit 10 Digit
* * * * * *
Number* Number

VILL AND P Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9161955509
VILL MOHANLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 7310298833
UPSDM100@Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 8052635567
VILL INDRA Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9896932495
VILL GAURIYLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9721816602
VILL AND POLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9053184750
VILL AND P Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 7408564846
VILLMAKHANLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 8931815139
VILL BELWA Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9984507032
VILL AND POLakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 9839539151
VILL AND POLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9053184750
VILL AND P Lakhimpur Lakhimpur KhUttar Pradesh 262905 Lakhimpur India 9670971808
VILL CHAND Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 7007047737
VILL AND POLakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 7408713613
VILL LAKHA Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 9984360841
VILL BOJHIYLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9792481954
VILL BANGA Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 7054519810
moh. tharvaraLakhimpur Lakhimpur KhUttar Pradesh 262701 Lakhimpur India 7651820409
VILL LONIY Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 8948884742
MAJHRIYA P Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 8874329794
VILL CHAND Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 9554645410
VILL SOHAR Lakhimpur Lakhimpur KhUttar Pradesh 262724 Lakhimpur India 9517388989
VILL GAURIYLakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9721816602
VILL NAREN Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9670845102
VILL AND P Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 8948503609
VILL AND P Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 9519611501
VILL BELWA Lakhimpur Lakhimpur KhUttar Pradesh 262907 Lakhimpur India 7651963911

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 125130390575

32 33 34 35 36 37

NoOfYearsOf NoOfMonths
CandidateLand PreviousExpe OfPreviousEx EducationLev Technical
CandidateEmailId
lineNo el Education
rience perience

11 Digit 0-2 digit 0-3 digit *

Number Number Number

abcd@abc.com
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None
05224025494 upsdm.100@gmail.com 0 0 10th None

Page 5
 125130390575
Batch Creation ( Will be prepopulated as the Batch is created i
38 39 1 2 3 4 5

SourceOfMobiliza DetailsOfMobilization TypeOfTraini SDMSEnrolm BatchStartDat

CourseId TrainerID
tion ng entNumber e

Training Partner Through Counseling

Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling
Training Partner Through Counseling

Page 6
 125130390575
as the Batch is created in application. System needs to generate the Enrollment Number)
6 7 8 9 10 11 12 13

BatchEndDat CourseFee FeePaidBy CentreID CenterName TcState TcDistrict TcPINCode

e

Page 7
 125130390575
nt Number) Training Details Assessment Details
14 1 2 1 2 3 4 5

CandidateAss
SectorCovere TrainingStatu CandidateTrai
ningAttendan AssessmentA Assessment Assessment essmentmtA
Assessor
d s gency From Date To Date ttendancePer
cePercentage centage

Completed/P 0-100 0-100

* * * *
ending* Number* Number*

Completed 88.00%
Completed 83.00%
Completed 84.00%
Completed 85.00%
Completed 88.00%
Completed 83.00%
Completed 89.00%
Completed 89.00%
Completed 89.00%
Completed 88.00%
Completed 88.00%
Completed 88.00%
Completed 83.00%
Completed 84.00%
Completed 89.00%
Completed 88.00%
Completed 87.00%
Completed 87.00%
Completed 87.00%
Completed 89.00%
Completed 86.00%
Completed 86.00%
Completed 87.00%
Completed 85.00%
Completed 88.00%
Completed 86.00%
Completed 87.00%

Page 8
 125130390575
Certification Details Placement Details
6 1 2 3 4 5 1 2

CertifyingAge CertificationD CertificateNa CertificateNo PlacementSta EmploymentT

Grade Certified
ncy ate meOrAward tus ype

0-100 DD/MM/YYY
* Y/N* * * * *
Number* Y*

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 125130390575

3 4 5 6 7 8 9 10

UndertakingF EmployerNa EmployerCon EmployerCon

Apprenticeshi orSelfEmploy Proofofupskil Typeofproof DateofJoining meOrSelfEmp tactPersonNa tactPersonDe
p edCollectedFr lingprovided loyed me signation
omCandidate

* * * * * * * *

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 125130390575

11 12 13 14 15 16 17 18

Feedbackcoll frequencyoffe Stateofplace Districtofplac MonthlyEarni

Employercont Locationofem Locationofem ectedfromem
mentORwork ementORwor ngOrCTCbefor
actNo ployerState ployerDistrict edback
ployer k eTraining

* * * * * * * Number*

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 125130390575

19 20 21 22 23 24 25 26

MonthlyCurr NSDCRegistra
entCTCOrear tionNumber CandidateID PlacementTra PlacementTra PlacementTra PlacementTra PlacementTra
ckingStatus1 ckingDate1 ckingStatus2 ckingDate2 ckingStatus3
ning

Number* * * * * * *

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 125130390575

27

PlacementTra
ckingDate3

Page 13