Online Application Form

Data Analyst (E-Hospital),MIS

Recruitment for NHM, UP
Application No.: SAMSUPNHM0061914
Post Applied for: Data Analyst (E-Hospital),MIS
Candidate's Name: Mr. Ankit
Father's/ Husband's Name: late munna lal
Gender: MALE
Date of Birth (DD/MM/YY): 01-Jan-1997
Mobile Number: 9650893208
Alternate Number: 7017739274
Email ID: kushsingh4312@gmail.com
Are you fall in the category of differently abled? NO
Category: OBC
Domicile State: Uttar Pradesh
Domicile District: Mainpuri
Preference: Lucknow,

2. Address:

Correspondence/ Current Address with Pin Code: Permanent Address with Pin Code:
house no 1 kardam puri near shani bazar 110094 kosma hinood post & village kosma 205119

3. Educational Qualification Details:

Essential Qualification*

Name of the
Specialization & Principal Name of University/ Passing Marks (in
Degree/ Mode Of Course
Subjects Institute Year %)
Diploma
Graduate
political,history delhi university Full Time APR-2017 60.1
Degree
Diploma in
surya institute of technical
Computer computer application Full Time NOV-2015 0
education
Applications

Other Qualifications

Name of the
Specialization & Principal Name of University/ Passing Marks (in
Degree/ Mode Of Course
Subjects Institute Year %)
Diploma
10th social studies cbse Full Time JUN-2012 62.6
12th political cbse Full Time MAY-2014 66.6

4. Work Experience:

Key Ares of Experience &

Name of Organisation Designation / Title Experience Duration
Job Responsibilities
thakur apparels pvt.ltd. facility manager all kind of maintanance 14-Oct-16 to 30-Aug-18

Declaration by Candidate: I hereby declare that the information furnished above is true to the best of my knowledge
and any misrepresentation, falsification or omission of information used to secure employment shall be grounds for
rejection of this application and I would liable for legal action, also immediate discharge if I am employed by NHM, UP
regardless of the time elapsed before discovery.

Date: 28-Jan-2019