KH/HR/FMT/JA-01
RECENT
PHOTO
Name : ____________(Surname)___________________(Name)____________________(Middle)
Father’s /Husband Name : ___________________________________________
Designation Applied for : ___________________________________________
Postal Address : ___________________________________________
___________________________________________
Date of Joining : ___________________________________________
PERSONAL DATA FORM
Full Name (Before Marriage if Any)_________________________________________________________________________
Date of Birth ___________________ Weight __________________ Height _____________
Email ID ____________________________________ Contact No._______________________/ ____________________________
FAMILY DETAILS
AGE / SEX RELATION OCCUPATION
NAME
EDUCATION QUALIFICATION (Start with School Leaving Certificate or Equivalent)
YEAR OF % MAJOR
QUALIFICATION UNIVERSITY / INSTITUTE PASSING MARKS SUBJECT
ADDITIONAL INFORMATION
Languages Known: ______________________________________________________________
Your Hobbies: __________________________________________________________________
Your Interests: __________________________________________________________________
Are you related to any of our employees? If Yes his/her Name: _____________________
Membership of any Professional Institution/Association: __________________________
_______________________________________________________________________________
Any Specialized Training/Training Program attended: ___________________________________
Any Other information: __________________________________________________
EMERGENCY DETAILS
Blood Group: ________________ Allergic To: _________________________
Any Illness: __________________________________________________________
Contact Person and contact No. in case of Emergency:
_______________________________________________________
ATTACHMENTS
No Documents Submitted Will submit on
1 2 passport photo
2 All Educational Document ( SSC,HSC, ANM,
GNM BAMS, BHMS, MBBS, Marksheet)
3 Degree Certificate
4 Registration Certificate
5 Adhar Card, Pan Card
6 Bank Passbook Xerox
DECLARATION
I declare that the information given, herein above, is true & correct to the best of my knowledge & belief & nothing material has been
concealed. I understand that the above information in found false or incorrect, at any time during the course of my employment, my
services will be terminated forthwith without any notice or compensation.
DATE: _______________________ _________________________________
PLACE: _______________________ SIGNATURE OF APPLICANT
