Bangladesh Public Service Commission http://bpsc.teletalk.com.bd/ncad/final.php?invoiceno=NBRDYTLDTQ ...

Government of the People's Republic of Bangladesh

Bangladesh Public Service Commission Applicant's Copy
Application Form for Non-Cadre Examination [BPSC Form - 5 A]
Application for Ministry of Health and Family Welfare

User ID: NBRDYTLDTQ Ref: 35-44/2020 | Last Date: 26 July 2020

Post Name Inspector of Drugs

Exam Centre CHITTAGONG
Applicant's Name TUSNOVA SHARMIN
Father's Name MD. KAMRUL KARIM CHOWDURY
Mother's Name ROKEYA BEGUM
Date of Birth 1992-07-03 [YYYY-MM-DD] 27 Years 10 Months 30 Days
Gender Female

Freedom Fighter Status Non Freedom Fighter Ethnic Minority No

Married - Spouse Name: MD. KIBRIA
Marital Status Physically Handicapped No
SIDDIQUE
Nationality/NID Bangladeshi/1495276717 Home District Chattogram

Present Address: Permanent Address:

Care of: MD. KAMRUL KARIM CHOWDURY Care of: MD. KAMRUL KARIM CHOWDURY
Village/Town: East Sholosahar.Bahaddar Bari, Bahaddar Hat Village/Town: East Sholosahar.Bahaddar Bari, Bahaddar Hat
Chandgaon,Chittagong- 4212 Chandgaon,Chittagong- 4212
Post Office: Chandgaon Post Office: Chandgaon
Post Code: 4212 Post Code: 4212
Upazilla/Thana: Chandgaon Upazilla/Thana: Chandgaon
District: Chattogram District: Chattogram

Academic Qualifications:

Examination Board/Institute Group/Subject/Degree Result Year Roll Duration

S.S.C Chittagong Science 5 2007 106923 N/A

H.S.C Chittagong Science 5 2009 103120 N/A
Noakhali Science &
Honours Pharmacy 3.66 2013 N/A 04
Technology University
Noakhali Science &
M. Pharm Pharmacy 3.72 2014 N/A 01
Technology University

Enclosure: [Attested Certificates/Equivalent Certificates to be Submitted Later According to Tick Mark]

01. Recent Passpost Size Photograph | 02. Admit Card | 03. S. S. C. or Equivalent Certificate | 04. H. S. C. or Equivalent
Certificate | 05. Graduation or Equivalent Certificate | 06. Masters Degree or Equivalent Certificate | 12. National ID |

I declare that the information provided in this form are correct, true and complete to the best of my knowledge
and belief. If any information is found false, incorrect, incomplete or if any ineligibility is detected before or after
the examination, any action can be taken against me by the Commission including cancellation of my candidature.

-------------- Applicant's Signature --------------

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