22/04/2022, 16:54 Registration Slip 4220129354

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BIHAR STAFF SELECTION COMMISSION
P.O-VETERINARY COLLEGE, PATNA - 800014
ADVERTISEMENT NO. 01/2022

PERSONAL DETAILS
REGISTRATION NO.: 4220129354
FORM NO. : 5220129354
NAME OF APPLICANT : ANURAG MISHRA
FATHER'S NAME : RAM KIRAT MISHRA
MOTHER'S NAME : SHARDA MISHRA
GENDER : MALE
MOBILE NO. : 9044585074
EMAIL ID : ANURAGMISHRA1891@GMAIL.COM
DATE OF BIRTH : 08-05-1991 PHOTO

AGE AS ON 01-08-2021 : 30 YEARS, 2 MONTHS, 24 DAYS

AGE AS ON 01-08-2015 : 24 YEARS, 2 MONTHS, 24 DAYS
NATIONALITY : INDIAN
SIGNATURE IN ENGLISH
CATEGORY : GEN

SIGNATURE IN HINDI

DOMICILE OF BIHAR STATE : NO

ARE YOU PERSON WITH DISABILITY? : NO
TYPE OF ID PROOF : AADHAAR CARD ID PROOF NO : 385203535743
BIHAR GOVERNMENT EMPLOYEE WHO HAS RENDERED NOT
NO
LESS THAN 3 YEARS REGULAR AND CONTINUOUS SERVICE? :
DO YOU HAVE EDUCATIONAL QUALIFICATION AS PER
YES
ADVERTISEMENT ? :
IDENTIFICATION MARK OF THE CANDIDATE : MOLE ON UPER LIP
ARE YOU AN EX-SERVICEMAN? : NO
WARD OF FREEDOM FIGHTER? : NO
ADDRESS DETAILS

CORRESPONDENCE ADDRESS PERMANENT ADDRESS

S/O RAM KIRAT MISHRA 9/3 OLD S/O RAM KIRAT MISHRA 9/3 OLD COLONY
ADDRESS: ADDRESS:
COLONY AISHBAGH LUCKNOW AISHBAGH LUCKNOW
VILLAGE/MUHALLA: AISHBAGH VILLAGE/MUHALLA: AISHBAGH

POST OFFICE: RAJENDRA NAGAR POST OFFICE: RAJENDRA NAGAR

POLICE STATION: AISHBAGH POLICE STATION: AISHBAGH

DISTRICT: LUCKNOW DISTRICT: LUCKNOW

STATE: UTTAR PRADESH STATE: UTTAR PRADESH
PIN CODE: 226004 PIN CODE: 226004
EDUCATIONAL QUALIFICATIONS
EDUCATION SUBJECT BOARD/UNIVERSITY/INSTITUTE PASSING YEAR CERTIFICATE
NUMBER
HINDI ENGLISH MATHEMATICS
10TH / SCIENCE HISTORY ENVIRONMENT
C I S C E NEW DELHI 2008 60093626
EQUIVALENT SCIENCE COMPUTER
APPLICATION
MECHANICAL AND AUTOMATION
GRADUATION AMITY UNIVERSITY 2014 A7605410083
ENGINEERING SUBJECTS
PAYMENT DETAILS:
PAYMENT BANK : SBI
TRANSACTION ID : 4412388528130
TRANSACTION DATE : 2022-04-22 16:05:54
REGISTRATION FEE (RS.) : 540
DECLARATION DETAILS:
I HEREBY DECLARE THAT I AM A CITIZEN OF INDIA. THE ENTRIES IN THIS APPLICATION FORM ARE COMPLETE, TRUE AND CORRECT TO THE
BEST OF MY KNOWLEDGE AND BELIEF. I HAVE READ CAREFULLY ALL THE EXAMINATION RULES AND PROVISIONS RELATED TO THIS
ADVERTISEMENT AND I PROMISE TO FOLLOW THESE AND ALSO PROMISE THAT I WILL NOT USE ANY UNFAIR MEANS DURING EXAMINATION.
I FULFILL ALL THE ELIGIBILITY CRITERIA I.E. AGE LIMIT, EDUCATIONAL QUALIFICATION TODAY AS PRESCRIBED IN THE ADVERTISEMENT. I
HAVE ALL THE ELIGIBILITY CERTIFICATES, WHENEVER THE BSSC WILL ASK FOR IT I WILL PRODUCE THE SAME FAILING WHICH MY
CANDIDATURE CAN BE CANCELLED BY THE BSSC AT ANY TIME. IN CASE OF ANY INFORMATION PROVIDED BY ME FOUND TO BE FALSE OR
INCORRECT BEFORE OR AFTER THE EXAMINATION, THE BSSC CAN CANCEL MY CANDIDATURE AND ALSO INITIATE THE LEGAL
PRECEDINGS AGAINST ME. I DECLARE THAT I HAVE FILLED ONLY ONE APPLICATION FORM FOR THIS EXAMINATION.
DATE : 22-04-2022
PLACE: LUCKNOW
DECLARATION ACCEPTED : YES

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