Candidate Registration Fields

1 2 3
Salutation FullName Gender

Input field,
Mr, Input field
Ms, Male,
Mrs, Input field Female,
Mx * Text (50) * Transgender *
Mr Panchanan Samal Male
Mr Santosh Kumar Malik Male
Mr Shreedhar Malik Male
Mr Bhagiratha Malik Male
Mr Dilip Kumar Barik Male
Mr Shivsundar Majhi Male
Mr Padmalochan Sahu Male
Mr Shreedhar Nath Male
Mr Narottam Samal Male
Mr Tapas Kumar Samal Male
Mr Ranjan Kumar Agasti Male
Mr Rajesh Kumar Malik Male
Mr Prafulla Kumar Behera Male
Mr Chandrakanta Behera Male
Mr Afroj Saha Male
Mr Anil Malik Male
Mr Bidyadhar Malik Male
Mr Satyajit Nayak Male
Mr Satyasundar Jena Male
Mr Mayadhar Jena Male
Mr Kailash Jena Male
Mr Ujal Kanta Jena Male
Mr Akash Kumar Jena Male
Mr Prasanta Kumar Bijuli Male
Mr Sania Dalai Male
Mr Prashanta Biswal Male
Mr Susanta Kumar Das Male
Mr Uttam Rout Male
Mr SK Sakiruddin Male
Mr Chinmay Giri Male
 4 5 6 7
DateofBirth EmailID MaritalStatus FathersName

Input Field
Single/Unmarried,
Married, Input field
Input field Widowed, Text (50)
Input field Alphanumeric (50) Divorced, Either Father or
DD/MM/YYYY format with email address Separated,Not to be Guardian Name
* validations * Disclosed Mnadatory *
01/05/1981 panchanan.samal@gmaMarried Sachindra Samal
15/01/2003 santosh.malik@gmail. Single/Unmarried Anil Malik
01/01/1970 shreedhar.malik@gmaiMarried Bipir Malik
17/01/2000 bhagiratha.malik@gmaMarried Chaitanya Malik
06/02/1986 dilip.barik@gmail.com Married Naba Kishor Bari
20/05/1993 shivsundar.majhi@gmaMarried Nirajan Majhi
06/06/1975 padmalochan.sahu@gmMarried Narendra Sahu
28/04/1976 shreedhar.nath@gmailMarried Bharat Nath
14/05/1996 narottam.samal@gmailMarried Nirakar Samal
14/05/1997 tapas.samal@gmail.co Married Nirakar Samal
30/05/1994 ranjan.agasti@gmail.c Married Rabindra Agasti
01/08/1995 rajesh.malik@gmail.co Married Gajendra Malik
24/05/1998 prafulla.behera@gmailMarried Ganesh Chandra
08/02/1996 chandrakanta.behera@Married Bhaskar Behera
01/01/1998 afroj.saha@gmail.com Married Farid Saha
01/01/1975 anil.malik@gmail.com Married Shyamsundra Mal
01/01/1982 bidyadhar.malik@gmaiMarried Bhima Malik
14/04/1997 satyajit.nayak@gmail. Married Madhusuadn Nay
10/02/2001 satyasundra.jena@gmaMarried Bhaskar Jena
01/01/1987 mayadhar.jena@gmail Married Krupasindhu Jena
10/03/1995 kailash.jena@gmail.co Married Sukadeva Jena
01/01/2002 ujalkanta.jena@gmail. Married Ramakanta Jena
20/11/2001 akash.jena@gmail.comMarried Laxman Jena
05/04/1994 prasanta.bijuli@gmail. Married Satrughana Bijuli
28/05/1994 sania.dalai@gmail.comMarried Lochan Dalai
01/01/1969 prashanta.biswal@gmaMarried Sitanath Biswal
01/01/1979 sushanta.das@gmail.c Married Kishore Chandra
26/02/1991 uttam.rout@gmail.comMarried Ganapati Rout
01/08/1982 sk.sakiruddin@gmail.c Married Sek Megha
25/05/1994 chinmay.giri@gmail.co Married Rabindra Giri
 8 10 9 11
MothersName GuardiansName Religion Category

Input field.
Atheist,
Hindu,
Sikh, Input field.
Muslim, General,
Christian, OBC,
Input field Buddhist, SC,
Text (50) Jews, ST,
Input field Either Father or Guardian Other, Not to be
Text (50) * Name Mnadatory * Not to be Disclosed * Disclosed *
Sabitri Samal Sachindra Samal Hinduism
Hena Malik Anil Malik Hinduism
Bharati Malik Bipir Malik Hinduism
Basanti Malik Chaitanya Malik Hinduism
Sita Barik Naba Kishor Barik Hinduism
Sapani Majhi Nirajan Majhi Hinduism
Priyanka Sahu Narendra Sahu Hinduism
Phuli Nath Bharat Nath Hinduism
Damini Samal Nirakar Samal Hinduism
Janaki Samal Nirakar Samal Hinduism
Sakuntala Agasti Rabindra Agasti Hinduism
Laxmi Malik Gajendra Malik Hinduism
Laxmi Behera Ganesh Chandra Behera Hinduism
Saba Behera Bhaskar Behera Hinduism
Tania Bibi Farid Saha Hinduism
Sangita Malik Shyamsundra Malik Hinduism
Anita Malik Bhima Malik Hinduism
Surati Nayak Madhusuadn Nayak Hinduism
Sundari Jena Bhaskar Jena Hinduism
Damini Jena Krupasindhu Jena Hinduism
Laxmipriya Jena Sukadeva Jena Hinduism
Henabati Jena Ramakanta Jena Hinduism
Harapriya Jena Laxman Jena Hinduism
Hirabati Bijuli Satrughana Bijuli Hinduism
Minati Dalai Lochan Dalai Hinduism
Himadri Biswal Sitanath Biswal Hinduism
Jayanti Das Kishore Chandra Das Hinduism
Droupadi Rout Ganapati Rout Hinduism
Niarajan Bibi Sek Megha Others
Jamuna Giri Rabindra Giri Hinduism
 Input field
If Disability field selected as "Yes",
mandatory to select from the list below.
12 13
Locomotor Disability, Leprosy Cured
Disability TypeofDisability
Person, Dwarfism,
Acid Attack Victims, Blindness/Visual
Impairment,
Low-vision (Visual Impairment), Deaf,
Hard of Hearing,
Speech and Language Disability,
Intellectual Disability /Mental
Retardation,
Autism Spectrum Disorder, Specific
Learning Disabilities, Mental Behavior-
Mental Illness, Haemophilia, Thalassemia,
Input field Sickle Cell Disease, Deaf Blindness,
Yes, Cerebral Palsy, Multiple Sclerosis,
No * Muscular Dystrophy *
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
 14 15
DomicileState DomicileDistrict

Input field Input field

Based on LGD List * Based on LGD List *
 16 17
IDType TypeofAlternateID

Input field
Not to be filled if selected as Aadhar ID in the ID Type.
PAN Card, Voter ID Card, Domicile Certificate, ST/SC
Input Field Certificate, Permanent Residential Certificate (PRC),
Alternate ID. Driving License, Ration Card, Birth Certificate issued by
Aadhar ID govt., BPL Card, National Population Register (NPR)
*** If selected as Aadhar ID, Card, Identity proof by Gazetted officers, Passport, Jail
Aadhar No. to be updated and Identification Card / Number, School leaving certificate
verified from the Application / 10th certificate, Letter of domicile from SDM / DM /
directly. * Govt. Authority,Other *
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
aadhar
 19 20 21
IDNo CountryCode MobileNo

Input field
Not to be filled if selected as Input field
Aadhar ID in the ID Type. * Input field * Numeric (10) *
+91 9.015734646e+09
+91 8.925019185e+09
+91 8.658828121e+09
+91 7.02137104e+09
+91 8.78073862e+09
+91 6.370089643e+09
+91 8.240201947e+09
+91 9.76994246e+09
+91 8.917505425e+09
+91 9.284981366e+09
+91 7.827876995e+09
+91 6.370060292e+09
+91 8.144058118e+09
+91 7.35872832e+09
+91 8.600477118e+09
+91 8.925019185e+09
+91 9.668818334e+09
+91 6.37222495e+09
+91 7.483201464e+09
+91 7.989672579e+09
+91 9.811107602e+09
+91 7.624837822e+09
+91 7.749879713e+09
+91 7.989672579e+09
+91 9.019343481e+09
+91 7.894038513e+09
+91 8.328942074e+09
+91 9.746826439e+09
+91 8.65829496e+09
+91 8.210772948e+09
 22 23 24
EducationLevel PermanentAddressAddress PermanentAddressState

Input field
From the List of Education Input field Input field
Qualifications * Alphanumeric (50) * From LGD List *
6th Class Jageswarpada ODISHA
6th Class Jirital ODISHA
7th Class Jirital ODISHA
10th Class Jagannathpur ODISHA
5th Class Gopalpur ODISHA
5th Class Kharasahapur ODISHA
5th Class Bagalpur ODISHA
5th Class Saud ODISHA
10th Class Kharasahapur ODISHA
10th Class Kharasahapur ODISHA
10th Class Avana ODISHA
10th Class Osanga ODISHA
10th Class Panapana ODISHA
10th Class Thalasada ODISHA
10th Class sahaspura ODISHA
6th Class Jirital ODISHA
5th Class Jirital ODISHA
10th Class Ramadha Nayak ODISHA
10th Class Karanjabindha ODISHA
5th Class Karanjabindha ODISHA
10th Class Karanjabindha ODISHA
10th Class Karanjabindha ODISHA
10th Class Karanjabindha ODISHA
10th Class Karanjabindha ODISHA
5th Class Sahasapura ODISHA
5th Class Jirital ODISHA
8th Class Karanjabindha ODISHA
10th Class Uparaadhia ODISHA
5th Class Uparaadhia ODISHA
10th Class Jirital ODISHA
 25 26 27
PermanentAddressDistrict PermanentAddressPINCode PermanentAddressCity

Input field Input field Input field

From LGD List * Numeric (07) * From LGD List
BALESHWAR 756044
BALESHWAR 756043
BALESHWAR 756043
BALESHWAR 756044
BALESHWAR 756044
BALESHWAR 756051
BALESHWAR 756042
BALESHWAR 756042
BALESHWAR 756046
BALESHWAR 756046
BALESHWAR 756051
BALESHWAR 756044
BALESHWAR 756043
BALESHWAR 756042
BALESHWAR 756046
BALESHWAR 756043
BALESHWAR 756043
BALESHWAR 756046
BALESHWAR 756044
BALESHWAR 756044
BALESHWAR 756044
BALESHWAR 756044
BALESHWAR 756044
BALESHWAR 756044
BALESHWAR 756046
BALESHWAR 756043
BALESHWAR 756044
BALESHWAR 756051
BALESHWAR 756051
BALESHWAR 756043
 28 29 30
PermanentAddressTehsil PermanentAddressConstituency CommunicationSameasPermanentA

Input field
Input field Input field Yes,
From LGD List From LGD List * No *
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
Balasore Yes
 31 32 33
CommunicationAddressState CommunicationAddressDistrict CommunicationAddressPINCode

Input field Input field Input field

From LGD List From LGD List From LGD List
If selected as Yes in If selected as Yes in If selected as Yes in
"Communication Same as "Communication Same as "Communication Same as
Permanent Address", this field is Permanent Address", this field is Permanent Address", this field is
non-mandatory. * non-mandatory. * non-mandatory.*
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756043
ODISHA BALESHWAR 756043
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756051
ODISHA BALESHWAR 756042
ODISHA BALESHWAR 756042
ODISHA BALESHWAR 756046
ODISHA BALESHWAR 756046
ODISHA BALESHWAR 756051
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756043
ODISHA BALESHWAR 756042
ODISHA BALESHWAR 756046
ODISHA BALESHWAR 756043
ODISHA BALESHWAR 756043
ODISHA BALESHWAR 756046
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756046
ODISHA BALESHWAR 756043
ODISHA BALESHWAR 756044
ODISHA BALESHWAR 756051
ODISHA BALESHWAR 756051
ODISHA BALESHWAR 756043
 34 35 36
CommunicationAddressCity CommunicationAddressTehsil CommunicationAddressPermanentC

Input field
From LGD List
If selected as Yes in
"Communication Same as
Input field Permanent Address", this field is
From LGD List Input field non-mandatory. *
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
Balasore
 37 38 39
PreTrainingStatus PreviousExperienceSector Noofmonthsofpreviousexperience

Input field
Input field Sector Master List Value from 1 to 500
Fresher, ***Required only if selected as ***Required only if selected as
Experienced * Experienced * Experienced *
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 40 41 42
Employed EmploymentStatus EmploymentDetails

Input field
Employed through Partner,
Employed through Employer,
Input field Upskilled,
Yes/No, Opted for Higher Studies, Input field
Mandatory if selected as Self Employed Mandatory if selected as
Experienced * Mandatory if selected as Experienced
Experienced Text (100)
 Training Details
43 44 1 2
HeardAboutUs CandidateID TrainingStatuCandidateTra

System Generated
Input Field
Internet,
Friends/Relatives,
Kaushal Mela, Completed
Newsletter, / 0-100
Others Dropout * Number *
CAN_11348004
CAN_11350236
CAN_11350759
CAN_11350955
CAN_11351303
CAN_11357372
CAN_11357394
CAN_11357406
CAN_11357412
CAN_11357418
CAN_11357466
CAN_11357488
CAN_11357529
CAN_11357584
CAN_11357592
CAN_11358995
CAN_11359015
CAN_11359033
CAN_11359056
CAN_11359065
CAN_11359078
CAN_11359096
CAN_11359131
CAN_11360905
CAN_11364482
CAN_11401987
CAN_11402601
CAN_11402617
CAN_11402636
CAN_11409699
Batch Details (Will be prepopulated as the Batch is created in application)
1 2 3 4
SDMSEnrolmentNumber SkillingCategory BatchID BatchStartDate

System populated from System populated from System populated from

System populated from Batch Batch (After Candidate Batch (After Candidate Batch (After Candidate
(After Candidate Enrolment in the Enrolment in the Batch) Enrolment in the Batch) Enrolment in the Batch)
Batch) * * * *
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
PMKVY/STT/2020-2021/TP002542/TC041010/213313/CAN 213313 24/12/2020
 5 6 7 8 9
BatchEndDate TrainerID TrainerName CourseId CourseName

System System
populated from populated from
System populated from Batch (After Batch (After System populated from System populated from
Batch (After Candidate Candidate Candidate Batch (After Candidate Batch (After Candidate
Enrolment in the Batch) Enrolment in the Enrolment in the Enrolment in the Batch) Enrolment in the Batch)
* Batch) * Batch) * * *
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
27/02/2021 TR83943 pritam kumar Rana
 10 11 12 13
CourseType SectorCovered CourseFee FeePaidBy

QP/NOS Aligned or
Non-QP NOS Aligned.
System populated from System populated from System populated from System populated from
Batch (After Candidate Batch (After Candidate Batch (After Candidate Batch (After Candidate
Enrolment in the Batch) Enrolment in the Batch) Enrolment in the Batch) Enrolment in the Batch)
* * * *
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
pmkvy Construction
 14 15 16 17 18
TCID TCName TCCentre TCDistrict TCPINCode

System System System System System

populated from populated from populated from populated from populated from
Batch (After Batch (After Batch (After Batch (After Batch (After
Candidate Candidate Candidate Candidate Candidate
Enrolment in the Enrolment in the Enrolment in the Enrolment in the Enrolment in the
Batch) * Batch) * Batch) * Batch) * Batch) *
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
TC041010 PMKK Balasore ODISHA BALESHWAR 756044
Assessment Details (Column 1-8 Will be prepopulated as the Batch is submitted for Assessment in application)
1 2 3 4
Assessmentthrough(ModAssessmentAgencyI AssessmentAgencyName AssessorID

System
populated from
System populated Batch (Based on System populated from System populated from
from Batch (Based on Details selected Batch (Based on Details Batch (Based on Details
Details selected while submission selected while selected while
while submission for for Assessment) submission for submission for
Assessment) * * Assessment) * Assessment) *
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
SSC
sment in application)
5 6 7 8 9
Assessor AssessmentFromDatAssessmentToDate CandidateAssessmenAssessmentPercent

In %age (0-100
Number.
Upto 2 demical
places)
System System Will be Will be
populated from populated from autopopulated as autopopulated as
System populated from Batch (Based on Batch (Based on SSC, if SSC, if
Batch (Based on Details Details selected Details selected Assessment Assessment
selected while while submission while submission Mode is SSC. Mode is SSC.
submission for for Assessment) for Assessment) Pass/Fail/Not- Orelse, will be an
Assessment) * * * Appeared * input field.
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
05/03/2021 05/03/2021
 Input field
Certification Details Placement Details Mandator
y if
1 2 3 4 5 1 2 3 4
Employm
CertifyingAgency Certified Certificatio
Will be NameoftheCeCertificateNPlacementStEmploymentApprenticesUndertaking
ent Type
autopopu is
Will be lated as Will be Input selected
autopopu SSC, if System autopopu field. as Self
lated as Assessme populated lated as *Salaried Employed
SSC, if nt Mode from SSC, if or Waged .
Assessme is SSC. Course Assessme *Self Not-
Will be nt Mode Orelse, Details nt Mode Employed mandator
autopopulated as is SSC. will be an (After is SSC. / y for
SSC, if Orelse, input field Candidate Orelse *UpSkille other
Assessment will be an in Enrolmen will be an d/ Employm
Mode is SSC. input DD/MM/ t in the unique *Opted ent
Orelse, will be an field. YYYY Batch) or input Input field for Higher Input field Types.
input field. * Yes/No * format * Input field field. * Yes/No * Studies * Yes/No * Yes/No *
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
 5 6 7 8 9 10 11 12 13 14
ProofOfUpskTypeofproofDateofJoini EmployerN EmployerCoEmployerCon
EmployerCoLocationofELocationofEFeedbackCo
Input
field.
Certifying
skill
Mandator enhance
y if ment
Employm from
ent Type employer
selected / Input field
is Promotio in
UpSkilled n/ DD/MM/ Input field Input field Input field Input field Input field Input field
Input field Increase YYYY Text (50) Text (50) Text (50) Numeric From LGD From LGD Input field
Yes/No * in salary * format * * * * (11) * List * List * Yes/No
 Placement Tracking Details
15 16 17 18 19 1
FrequencyofFeedback StateofPla DistrictofP MonthlyEarMonthlyCurPlacementTr

Input field Input field

Input field Input field Number Number
Input field From LGD From LGD 0-500000 0-500000 Input field
Monthly/Quaterly/Bi-Annually List * List * * * Yes/No
Placement Tracking Details
2 3 4 5 6
PlacementTrackingDate1PlacementTrackingStat PlacementTrackingDate2PlacementTrackingStat PlacementTrackingDate3

Input field in Input field Input field in Input field Input field in
DD/MM/YYYY format Yes/No DD/MM/YYYY format Yes/No DD/MM/YYYY format
rackingDate3
Salutation Gender Marital Status Category
Mr Male Single/Unmarried General
Ms Female Married OBC
Mrs Transgender Divorcee SC
Mx Widow ST
Widower Not disclosed
Disability Name Religion
Locomotor Disability Hindu
Leprosy Cured Person Sikh
Dwarfism Muslim
Acid Attack Victims Christian
Blindness /Visual Impairment Buddhist
Low-vision (Visual Impairment) Jews
Deaf Other
Hard of Hearing Not disclosed
Speech and Language Disability Atheist

Intellectual Disability /Mental Retardation

Autism Spectrum Disorder

Specific Learning Disabilities
Mental Behavior- Mental Illness
Haemophilia
Thalassemia
Sickle Cell Disease
Deaf Blindness
Cerebral Palsy
Multiple Sclerosis
Muscular Dystrophy
Parkinson's Disease
Country Name
India
Disability List
PAN Card
Voter ID Card
Domicile Certificate
ST/SC Certificate
Permanent Residential Certificate (PRC)
Driving License
Ration Card
Birth Certificate issued by Government
BPL Card

National Population Register (NPR) Card

Identity proof by Gazetted officers

Passport
Jail Identification Card/ Number
School leaving certificate/10th certificate
Letter of domicile from SDM/DM/Government Authority
ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH
NICOBARS ANANTAPUR ANJAW
NORTH AND MIDDLE ANDAMAN CHITTOOR CHANGLANG
SOUTH ANDAMANS EAST GODAVARI DIBANG VALLEY
GUNTUR EAST KAMENG
KRISHNA EAST SIANG
KURNOOL KAMLE
PRAKASAM KURUNG KUMEY
SPSR NELLORE Kra Daadi
SRIKAKULAM LOHIT

VISAKHAPATANAM LONGDING

VIZIANAGARAM LOWER DIBANG VALLEY

WEST GODAVARI LOWER SIANG
Y.S.R. LOWER SUBANSIRI
NAMSAI
PAPUM PARE
SIANG
TAWANG
TIRAP
UPPER SIANG
UPPER SUBANSIRI
WEST KAMENG
WEST SIANG
ASSAM BIHAR CHANDIGARH
BAKSA ARARIA CHANDIGARH
BARPETA ARWAL
BONGAIGAON AURANGABAD
Biswanath BANKA
CACHAR BEGUSARAI
CHARAIDEO BHAGALPUR
CHIRANG BHOJPUR
DARRANG BUXAR
DHEMAJI DARBHANGA

DHUBRI GAYA

DIBRUGARH GOPALGANJ
DIMA HASAO JAMUI
GOALPARA JEHANABAD
GOLAGHAT KAIMUR (BHABUA)
HAILAKANDI KATIHAR
HOJAI KHAGARIA
JORHAT KISHANGANJ
KAMRUP LAKHISARAI
KAMRUP METRO MADHEPURA
KARBI ANGLONG MADHUBANI
KARIMGANJ MUNGER
KOKRAJHAR MUZAFFARPUR
LAKHIMPUR NALANDA
MAJULI NAWADA
MARIGAON PASHCHIM CHAMPARAN
NAGAON PATNA
NALBARI PURBI CHAMPARAN
SIVASAGAR PURNIA
SONITPUR ROHTAS
SOUTH SALMARA MANCACHAR SAHARSA
TINSUKIA SAMASTIPUR
UDALGURI SARAN
WEST KARBI ANGLONG SHEIKHPURA
SHEOHAR
SITAMARHI
SIWAN
SUPAUL
VAISHALI
CHHATTISGARH DADRA AND NAGAR HAVELI DAMAN AND DIU DELHI GOA
BALOD DADRA AND NAGAR HAVELI DAMAN CENTRAL NORTH GOA
BALODA BAZAR DIU EAST SO
BALRAMPUR NEW DELHI
BASTAR NORTH
BEMETARA NORTH EAST
BIJAPUR NORTH WEST
BILASPUR SHAHDARA
DANTEWADA SOUTH
DHAMTARI SOUTH WEST

DURG South East

GARIYABAND WEST
JANJGIR-CHAMPA
JASHPUR
KABIRDHAM
KANKER
KONDAGAON
KORBA
KOREA
MAHASAMUND
MUNGELI
NARAYANPUR
RAIGARH
RAIPUR
RAJNANDGAON
SUKMA
SURAJPUR
SURGUJA
GUJARAT HARYANA HIMACHAL PRADESH JAMMU AND KASHMIR JHARKHAND
AHMADABADAMBALA BILASPUR ANANTNAG BOKARO
AMRELI BHIWANI CHAMBA BADGAM CHATRA
ANAND CHARKI DA HAMIRPUR BANDIPORA DEOGHAR
ARVALLI FARIDABAD KANGRA BARAMULLA DHANBAD
BANAS KA FATEHABAD KINNAUR DODA DUMKA
BHARUCH GURUGRAM KULLU GANDERBAL EAST SINGHBU
BHAVNAGA HISAR LAHUL AND SPITI JAMMU GARHWA
BOTAD JHAJJAR MANDI KARGIL GIRIDIH
CHHOTAU JIND SHIMLA KATHUA GODDA

DANG KAITHAL SIRMAUR KISHTWAR GUMLA

DEVBHUM KARNAL SOLAN KULGAM HAZARIBAGH

DOHAD KURUKSHE UNA KUPWARA JAMTARA
GANDHIN MAHENDRAGARH LEH LADAKH KHUNTI
GIR SOMN MEWAT POONCH KODERMA
JAMNAGAR PALWAL PULWAMA LATEHAR
JUNAGADH PANCHKULA RAJAURI LOHARDAGA
KACHCHH PANIPAT RAMBAN PAKUR
KHEDA REWARI REASI PALAMU
MAHESANA ROHTAK SAMBA RAMGARH
MORBI SIRSA SHOPIAN RANCHI
Mahisagar SONIPAT SRINAGAR SAHEBGANJ
NARMADA YAMUNANAGAR UDHAMPUR SARAIKELA K
NAVSARI SIMDEGA
PANCH MAHALS WEST SINGH
PATAN
PORBANDAR
RAJKOT
SABAR KANTHA
SURAT
SURENDRANAGAR
TAPI
VADODARA
VALSAD
KARNATAKA KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA
BAGALKOT ALAPPUZHALAKSHADWEEP DISTRICT
AGAR MALWA AHMEDNAGAR
BALLARI ERNAKULAM ALIRAJPUR AKOLA
BELAGAVI IDUKKI ANUPPUR AMRAVATI
BENGALURU R KANNUR ASHOKNAGAR AURANGABAD
BENGALURU U KASARAGOD BALAGHAT BEED
BIDAR KOLLAM BARWANI BHANDARA
CHAMARAJAN KOTTAYAM BETUL BULDHANA
CHIKBALLAPUR KOZHIKODE BHIND CHANDRAPUR
CHIKKAMAGAL MALAPPURAM BHOPAL DHULE

CHITRADURGA PALAKKAD BURHANPUR GADCHIROLI

DAKSHIN KAN PATHANAMTHITTA CHHATARPUR GONDIA

DAVANGERE THIRUVANANTHAPURAM CHHINDWARA HINGOLI
DHARWAD THRISSUR DAMOH JALGAON
GADAG WAYANAD DATIA JALNA
HASSAN DEWAS KOLHAPUR
HAVERI DHAR LATUR
KALABURAGI DINDORI MUMBAI
KODAGU EAST NIMAR MUMBAI SUBURBAN
KOLAR GUNA NAGPUR
KOPPAL GWALIOR NANDED
MANDYA HARDA NANDURBAR
MYSURU HOSHANGABAD NASHIK
RAICHUR INDORE OSMANABAD
RAMANAGARA JABALPUR PALGHAR
SHIVAMOGGA JHABUA PARBHANI
TUMAKURU KATNI PUNE
UDUPI KHARGONE RAIGAD
UTTAR KANNAD MANDLA RATNAGIRI
VIJAYAPURA MANDSAUR SANGLI
YADGIR MORENA SATARA
NARSINGHPUR SINDHUDURG
NEEMUCH SOLAPUR
PANNA THANE
RAISEN WARDHA
RAJGARH WASHIM
RATLAM YAVATMAL
REWA
SAGAR
SATNA
SEHORE
SEONI
SHAHDOL
SHAJAPUR
SHEOPUR
SHIVPURI
SIDHI
SINGRAULI
TIKAMGARH
UJJAIN
UMARIA
VIDISHA
 MANIPUR MEGHALAYA MIZORAM NAGALAND ODISHA PUDUCHERRY
BISHNUPUR EAST GARO HILLSAIZAWL DIMAPUR ANUGUL KARAIKAL
CHANDEL EAST JAINTIA H CHAMPHAI KIPHIRE BALANGI MAHE
CHURACHANDPUR EAST KHASI HIL KOLASIB KOHIMA BALESH PONDICHERRY
IMPHAL EAST NORTH GARO H LAWNGTLA LONGLENG BARGAR YANAM
IMPHAL WEST RI BHOI LUNGLEI MOKOKCHUN BHADRAK
JIRIBAM SOUTH GARO H MAMIT MON BOUDH
KAKCHING SOUTH WEST SAIHA PEREN CUTTACK
KAMJONG SOUTH WEST K SERCHHIP PHEK DEOGARH
KANGPOKPI WEST GARO HILLS TUENSANG DHENKANAL

NONEY WEST JAINTIA HILLS WOKHA GAJAPATI

PHERZAWL WEST KHASI HILLS ZUNHEBOTO GANJAM

SENAPATI JAGATSINGHAPUR
TAMENGLONG JAJAPUR
TENGNOUPAL JHARSUGUDA
THOUBAL KALAHANDI
UKHRUL KANDHAMAL
KENDRAPARA
BAI SUBURBAN KENDUJHAR
KHORDHA
KORAPUT
MALKANGIRI
MAYURBHANJ
NABARANGPUR
NAYAGARH
NUAPADA
PURI
RAYAGADA
SAMBALPUR
SONEPUR
SUNDARGARH
PUNJAB RAJASTHAN SIKKIM TAMIL NADU TELANGANA TRIPURA UTTAR PRADESH
AMRITSAR AJMER EAST DISTRICT
Ariyalur ADILABAD Dhalai AGRA
BARNALA ALWAR NORTH CHENNAI BHADRADRI Gomati ALIGARH
BATHIND BANSWARA SOUTH COIMBATORE HYDERABAD Khowai ALLAHABAD
FARIDKO BARAN WEST D CUDDALORE JANGOAN North Tri AMBEDKAR NAGAR
FATEHG BARMER DHARMAPURI JAYASHANKAR Sepahijala AMROHA
FAZILKA BHARATPUR DINDIGUL JOGULAMBA South Tri AURAIYA
FIROZEP BHILWARA ERODE Jagitial Unakoti AZAMGARH
GURDAS BIKANER KANCHIPURAM KAMAREDDY West Tri Amethi
HOSHIA BUNDI KANNIYAKUMA KARIMNAGAR BAGHPAT

JALANDH CHITTORGARH KARUR KHAMMAM BAHRAICH

KAPURT CHURU KRISHNAGIRI KUMURAM BHEEM ASIFABA BALLIA

LUDHIAN DAUSA MADURAI MAHABUBABAD BALRAMPUR
MANSA DHOLPUR NAGAPATTINA MAHABUBNAGAR BANDA
MOGA DUNGARPUR NAMAKKAL MANCHERIAL BARABANKI
PATHAN GANGANAGAR PERAMBALUR MEDAK BAREILLY
PATIALA HANUMANGARH PUDUKKOTTAI MEDCHAL MALKAJGIRI BASTI
RUPNAG JAIPUR RAMANATHAP NAGARKURNOOL BHADOHI
S.A.S Na JAISALMER SALEM NALGONDA BIJNOR
SANGRUR JALORE SIVAGANGA NIZAMABAD BUDAUN
SRI MU JHALAWAR THANJAVUR Nirmal BULANDSHAHR
Shahid JHUNJHUNU THE NILGIRIS PEDDAPALLI CHANDAULI
Tarn Tar JODHPUR THENI RAJANNA SIRCILLA CHITRAKOOT
KARAULI THIRUVALLUR RANGA REDDY DEORIA
KOTA THIRUVARUR SANGAREDDY ETAH
NAGAUR TIRUCHIRAPPAL SIDDIPET ETAWAH
PALI TIRUNELVELI SURYAPET FAIZABAD
PRATAPGARH TIRUPPUR VIKARABAD FARRUKHABAD
RAJSAMAND TIRUVANNAMA WANAPARTHY FATEHPUR
SAWAI MADHOPUR TUTICORIN WARANGAL RURAL FIROZABAD
SIKAR VELLORE WARANGAL URBAN GAUTAM BUDDHA NAGAR
SIROHI VILLUPURAM YADADRI BHUVANAGIRI GHAZIABAD
TONK VIRUDHUNAGAR GHAZIPUR
UDAIPUR GONDA
GORAKHPUR
HAMIRPUR
HAPUR
HARDOI
HATHRAS
JALAUN
JAUNPUR
JHANSI
KANNAUJ
KANPUR DEHAT
 KANPUR NAGAR
KAUSHAMBI
KHERI
KUSHI NAGAR
Kasganj
LALITPUR
LUCKNOW
MAHARAJGANJ
MAHOBA
MAINPURI
MATHURA
MAU
MEERUT
MIRZAPUR
MORADABAD
MUZAFFARNAGAR
PILIBHIT
PRATAPGARH
RAE BARELI
RAMPUR
SAHARANPUR
SAMBHAL
SANT KABEER NAGAR
SHAHJAHANPUR
SHAMLI
SHRAVASTI
SIDDHARTH NAGAR
SITAPUR
SONBHADRA
SULTANPUR
UNNAO
VARANASI
]
 UTTARAKHAND WEST BENGAL
ALMORA 24 PARAGANAS NORTH
BAGESHWAR 24 PARAGANAS SOUTH
CHAMOLI Alipurduar
CHAMPAWAT BANKURA
DEHRADUN BIRBHUM
HARIDWAR COOCHBEHAR
NAINITAL DARJEELING
PAURI GARHWALDINAJPUR DAKSHIN
PITHORAGARH DINAJPUR UTTAR

RUDRA PRAYAG HOOGHLY

TEHRI GARHWALHOWRAH
UDAM SINGH NAJALPAIGURI
UTTAR KASHI Jhargram
KALIMPONG
KOLKATA
MALDAH
MEDINIPUR EAST
MEDINIPUR WEST
MURSHIDABAD
NADIA
PASCHIM BARDHAMAN
PURBA BARDHAMAN
PURULIA

M BUDDHA NAGAR
FARNAGAR

ABEER NAGAR

RTH NAGAR
ANDAMAN AND NICOBAR ISLANDS ANDHRA PRADESH ARUNACHAL PRADESH
NICOBARS ANANTAPUR ANJAW
NORTH AND MIDDLE ANDAMAN CHITTOOR CHANGLANG
SOUTH ANDAMANS EAST GODAVARI DIBANG VALLEY
GUNTUR EAST KAMENG
KRISHNA EAST SIANG
KURNOOL KAMLE
PRAKASAM KURUNG KUMEY
SPSR NELLORE Kra Daadi
SRIKAKULAM LOHIT
VISAKHAPATANAM LONGDING
VIZIANAGARAM LOWER DIBANG VALLEY
WEST GODAVARI LOWER SIANG
Y.S.R. LOWER SUBANSIRI
NAMSAI
PAPUM PARE
SIANG
TAWANG
TIRAP
UPPER SIANG
UPPER SUBANSIRI
WEST KAMENG
WEST SIANG
ASSAM BIHAR CHANDIGA
BAKSA ARARIA CHANDIGARH
BARPETA ARWAL
BONGAIGAON AURANGABAD
Biswanath BANKA
CACHAR BEGUSARAI
CHARAIDEO BHAGALPUR
CHIRANG BHOJPUR
DARRANG BUXAR
DHEMAJI DARBHANGA
DHUBRI GAYA
DIBRUGARH GOPALGANJ
DIMA HASAO JAMUI
GOALPARA JEHANABAD
GOLAGHAT KAIMUR (BHABUA)
HAILAKANDI KATIHAR
HOJAI KHAGARIA
JORHAT KISHANGANJ
KAMRUP LAKHISARAI
KAMRUP METRO MADHEPURA
KARBI ANGLONG MADHUBANI
KARIMGANJ MUNGER
KOKRAJHAR MUZAFFARPUR
LAKHIMPUR NALANDA
MAJULI NAWADA
MARIGAON PASHCHIM CHAMPARAN
NAGAON PATNA
NALBARI PURBI CHAMPARAN
SIVASAGAR PURNIA
SONITPUR ROHTAS
SOUTH SALMARA MANCACHAR SAHARSA
TINSUKIA SAMASTIPUR
UDALGURI SARAN
WEST KARBI ANGLONG SHEIKHPURA
SHEOHAR
SITAMARHI
SIWAN
SUPAUL
VAISHALI
CHHATTISGARH DADRA AND NAGAR HAVELI DAMAN AND DIU DELHI GOA
BALOD DADRA AND NAGAR HAVELI DAMAN CENTRAL NORTH GOA
BALODA BAZAR DIU EAST SO
BALRAMPUR NEW DELHI
BASTAR NORTH
BEMETARA NORTH EAST
BIJAPUR NORTH WEST
BILASPUR SHAHDARA
DANTEWADA SOUTH
DHAMTARI SOUTH WEST
DURG South East
GARIYABAND WEST
JANJGIR-CHAMPA
JASHPUR
KABIRDHAM
KANKER
KONDAGAON
KORBA
KOREA
MAHASAMUND
MUNGELI
NARAYANPUR
RAIGARH
RAIPUR
RAJNANDGAON
SUKMA
SURAJPUR
SURGUJA
GUJARAT HARYANA HIMACHAL PRADESH JAMMU AND KASHMIR JHARKHAND KARNATAKA
AHMADABADAMBALA BILASPUR ANANTNAG BOKARO BAGALKOT
AMRELI BHIWANI CHAMBA BADGAM CHATRA BALLARI
ANAND CHARKI HAMIRPUR BANDIPORA DEOGHAR BELAGAVI
ARVALLI FARIDAB KANGRA BARAMULLA DHANBAD BENGALURU R
BANAS KA FATEHA KINNAUR DODA DUMKA BENGALURU U
BHARUCH GURUG KULLU GANDERBAL EAST SINGHBU BIDAR
BHAVNAGA HISAR LAHUL AND SPITI JAMMU GARHWA CHAMARAJAN
BOTAD JHAJJAR MANDI KARGIL GIRIDIH CHIKBALLAPUR
CHHOTAU JIND SHIMLA KATHUA GODDA CHIKKAMAGAL
DANG KAITHAL SIRMAUR KISHTWAR GUMLA CHITRADURGA
DEVBHUM KARNAL SOLAN KULGAM HAZARIBAGH DAKSHIN KAN
DOHAD KURUKS UNA KUPWARA JAMTARA DAVANGERE
GANDHIN MAHENDRAGARH LEH LADAKH KHUNTI DHARWAD
GIR SOMN MEWAT POONCH KODERMA GADAG
JAMNAGAR PALWAL PULWAMA LATEHAR HASSAN
JUNAGADH PANCHKULA RAJAURI LOHARDAGA HAVERI
KACHCHH PANIPAT RAMBAN PAKUR KALABURAGI
KHEDA REWARI REASI PALAMU KODAGU
MAHESANA ROHTAK SAMBA RAMGARH KOLAR
MORBI SIRSA SHOPIAN RANCHI KOPPAL
Mahisagar SONIPAT SRINAGAR SAHEBGANJ MANDYA
NARMADA YAMUNANAGAR UDHAMPUR SARAIKELA K MYSURU
NAVSARI SIMDEGA RAICHUR
PANCH MAHALS WEST SINGH RAMANAGARA
PATAN SHIVAMOGGA
PORBANDAR TUMAKURU
RAJKOT UDUPI
SABAR KANTHA UTTAR KANNAD
SURAT VIJAYAPURA
SURENDRANAGAR YADGIR
TAPI
VADODARA
VALSAD
 KERALA LAKSHADWEEP MADHYA PRADESH MAHARASHTRA MANIPUR
ALAPPUZHALAKSHADWEEP DISTRICT
AGAR MALWA AHMEDNAGAR BISHNUPUR
ERNAKULAM ALIRAJPUR AKOLA CHANDEL
IDUKKI ANUPPUR AMRAVATI CHURACHANDPUR
KANNUR ASHOKNAGAR AURANGABAD IMPHAL EAST
KASARAGOD BALAGHAT BEED IMPHAL WEST
KOLLAM BARWANI BHANDARA JIRIBAM
KOTTAYAM BETUL BULDHANA KAKCHING
KOZHIKODE BHIND CHANDRAPUR KAMJONG
MALAPPURAM BHOPAL DHULE KANGPOKPI
PALAKKAD BURHANPUR GADCHIROLI NONEY
PATHANAMTHITTA CHHATARPUR GONDIA PHERZAWL
THIRUVANANTHAPURAM CHHINDWARA HINGOLI SENAPATI
THRISSUR DAMOH JALGAON TAMENGLONG
WAYANAD DATIA JALNA TENGNOUPAL
DEWAS KOLHAPUR THOUBAL
DHAR LATUR UKHRUL
LABURAGI DINDORI MUMBAI
EAST NIMAR MUMBAI SUBURBAN
GUNA NAGPUR
GWALIOR NANDED
HARDA NANDURBAR
HOSHANGABAD NASHIK
INDORE OSMANABAD
AMANAGARA JABALPUR PALGHAR
IVAMOGGA JHABUA PARBHANI
UMAKURU KATNI PUNE
KHARGONE RAIGAD
TTAR KANNAD MANDLA RATNAGIRI
JAYAPURA MANDSAUR SANGLI
MORENA SATARA
NARSINGHPUR SINDHUDURG
NEEMUCH SOLAPUR
PANNA THANE
RAISEN WARDHA
RAJGARH WASHIM
RATLAM YAVATMAL
REWA
SAGAR
SATNA
SEHORE
SEONI
SHAHDOL
SHAJAPUR
SHEOPUR
SHIVPURI
SIDHI
SINGRAULI
TIKAMGARH
UJJAIN
UMARIA
VIDISHA
MEGHALAYA MIZORAM NAGALAND ODISHA PUDUCHERRY PUNJAB RAJASTHAN SIKKIM
EAST GARO HILLSAIZAWL DIMAPUR ANUGUL KARAIKAL AMRITSAR AJMER EAST DISTRICT
EAST JAINTIA H CHAMPHAI KIPHIRE BALANGI MAHE BARNALA ALWAR NORTH
EAST KHASI HIL KOLASIB KOHIMA BALESH PONDICHERRY BATHIN BANSWARA SOUTH
NORTH GARO H LAWNGTLA LONGLENG BARGAR YANAM FARIDKO BARAN WEST D
RI BHOI LUNGLEI MOKOKCHUN BHADRAK FATEHG BARMER
SOUTH GARO H MAMIT MON BOUDH FAZILKA BHARATPUR
SOUTH WEST SAIHA PEREN CUTTACK FIROZEP BHILWARA
SOUTH WEST K SERCHHIP PHEK DEOGARH GURDAS BIKANER
WEST GARO HILLS TUENSANG DHENKANAL HOSHIA BUNDI
WEST JAINTIA HILLS WOKHA GAJAPATI JALAND CHITTORGARH
WEST KHASI HILLS ZUNHEBOTO GANJAM KAPURT CHURU
JAGATSINGHAPUR LUDHIA DAUSA
JAJAPUR MANSA DHOLPUR
JHARSUGUDA MOGA DUNGARPUR
KALAHANDI PATHAN GANGANAGAR
KANDHAMAL PATIALA HANUMANGARH
KENDRAPARA RUPNAG JAIPUR
KENDUJHAR S.A.S Na JAISALMER
KHORDHA SANGRU JALORE
KORAPUT SRI MU JHALAWAR
MALKANGIRI Shahid JHUNJHUNU
MAYURBHANJ Tarn Ta JODHPUR
NABARANGPUR KARAULI
NAYAGARH KOTA
NUAPADA NAGAUR
PURI PALI
RAYAGADA PRATAPGARH
SAMBALPUR RAJSAMAND
SONEPUR SAWAI MADHOPUR
SUNDARGARH SIKAR
SIROHI
TONK
UDAIPUR
TAMIL NADU TELANGANA TRIPURA UTTAR PRADESH UTTARAKHAND WEST BENGAL
Ariyalur ADILABAD Dhalai AGRA ALMORA 24 PARAGANAS NORTH
CHENNAI BHADRADRI Gomati ALIGARH BAGESHWAR 24 PARAGANAS SOUTH
COIMBATORE HYDERABAD Khowai ALLAHABAD CHAMOLI Alipurduar
CUDDALORE JANGOAN North Tri AMBEDKAR NAGAR CHAMPAWAT BANKURA
DHARMAPURI JAYASHANKAR Sepahijala AMROHA DEHRADUN BIRBHUM
DINDIGUL JOGULAMBA South Tri AURAIYA HARIDWAR COOCHBEHAR
ERODE Jagitial Unakoti AZAMGARH NAINITAL DARJEELING
KANCHIPURAM KAMAREDDY West Tri Amethi PAURI GARHWAL DINAJPUR DAKSHIN
KANNIYAKUMA KARIMNAGAR BAGHPAT PITHORAGARH DINAJPUR UTTAR
KARUR KHAMMAM BAHRAICH RUDRA PRAYAG HOOGHLY
KRISHNAGIRI KUMURAM BHEEM ASIFABA BALLIA TEHRI GARHWAL HOWRAH
MADURAI MAHABUBABAD BALRAMPUR UDAM SINGH NA JALPAIGURI
NAGAPATTINA MAHABUBNAGAR BANDA UTTAR KASHI Jhargram
NAMAKKAL MANCHERIAL BARABANKI KALIMPONG
PERAMBALUR MEDAK BAREILLY KOLKATA
PUDUKKOTTAI MEDCHAL MALKAJGIRI BASTI MALDAH
RAMANATHAP NAGARKURNOOL BHADOHI MEDINIPUR EAST
SALEM NALGONDA BIJNOR MEDINIPUR WEST
SIVAGANGA NIZAMABAD BUDAUN MURSHIDABAD
THANJAVUR Nirmal BULANDSHAHR NADIA
THE NILGIRIS PEDDAPALLI CHANDAULI PASCHIM BARDHAMAN
THENI RAJANNA SIRCILLA CHITRAKOOT PURBA BARDHAMAN
THIRUVALLUR RANGA REDDY DEORIA PURULIA
THIRUVARUR SANGAREDDY ETAH
TIRUCHIRAPPAL SIDDIPET ETAWAH
TIRUNELVELI SURYAPET FAIZABAD
TIRUPPUR VIKARABAD FARRUKHABAD
TIRUVANNAMA WANAPARTHY FATEHPUR
TUTICORIN WARANGAL RURAL FIROZABAD
VELLORE WARANGAL URBAN GAUTAM BUDDHA NAGAR
VILLUPURAM YADADRI BHUVANAGIRI GHAZIABAD
VIRUDHUNAGAR GHAZIPUR
GONDA
GORAKHPUR
HAMIRPUR
HAPUR
HARDOI
HATHRAS
JALAUN
JAUNPUR
JHANSI
KANNAUJ
KANPUR DEHAT
KANPUR NAGAR
 KAUSHAMBI
KHERI
KUSHI NAGAR
Kasganj
LALITPUR
LUCKNOW
MAHARAJGANJ
MAHOBA
MAINPURI
MATHURA
MAU
MEERUT
MIRZAPUR
MORADABAD
MUZAFFARNAGAR
PILIBHIT
PRATAPGARH
RAE BARELI
RAMPUR
SAHARANPUR
SAMBHAL
SANT KABEER NAGAR
SHAHJAHANPUR
SHAMLI
SHRAVASTI
SIDDHARTH NAGAR
SITAPUR
SONBHADRA
SULTANPUR
UNNAO
VARANASI
]
AGANAS NORTH CompletedPass Yes Monthly Certifying Salaried or Waged
ARAGANAS SOUTH Dropout Fail No Quaterly Promotion Self Employed
Not-Appeared Bi-AnnuallyIncrease inUpSkilled
Opted for Higher Studies

JPUR DAKSHIN
JPUR UTTAR
Bi-

INIPUR EAST
INIPUR WEST
SHIDABAD

HIM BARDHAMAN
BA BARDHAMAN
Candidate ID Candidate Name Mobile
CAN_11409699 Chinmay Giri 8210772948
CAN_11402636 SK Sakiruddin 8658294960
CAN_11402617 Uttam Rout 9746826439
CAN_11402601 Susanta Kumar Das 8328942074
CAN_11401987 Prashanta Biswal 7894038513
CAN_11364482 Sania Dalai 9019343481
CAN_11360905 Prasanta Kumar Bijuli 7989672579
CAN_11359131 Akash Kumar Jena 7749879713
CAN_11359096 Ujal Kanta Jena 7624837822
CAN_11359078 Kailash Jena 9811107602
CAN_11359065 Mayadhar Jena 7989672579
CAN_11359056 Satyasundar Jena 7483201464
CAN_11359033 Satyajit Nayak 6372224950
CAN_11359015 Bidyadhar Malik 9668818334
CAN_11358995 Anil Malik 8925019185
CAN_11357592 Afroj Saha 8600477118
CAN_11357584 Chandrakanta Behera 7358728320
CAN_11357529 Prafulla Kumar Behera 8144058118
CAN_11357488 Rajesh Kumar Malik 6370060292
CAN_11357466 Ranjan Kumar Agasti 7827876995
CAN_11357418 Tapas Kumar Samal 9284981366
CAN_11357412 Narottam Samal 8917505425
CAN_11357406 Shreedhar Nath 9769942460
CAN_11357394 Padmalochan Sahu 8240201947
CAN_11357372 Shivsundar Majhi 6370089643
CAN_11351303 Dilip Kumar Barik 8780738620
CAN_11350955 Bhagiratha Malik 7021371040
CAN_11350759 Shreedhar Malik 8658828121
CAN_11350236 Santosh Kumar Malik 8925019185
CAN_11348004 Panchanan Samal 9015734646