ONLINE APPLICATION REGISTRATION FOR PHARMACIST 2025
USER ID MRBPHA25015035
POST APPLYING FOR PHARMACIST
PERSONAL DETAILS
NAME ARUNA R
NATIONALITY INDIAN
ARE YOU AN EX-SERVICEMEN NO
DO YOU HAVE COMMUNITY CERTIFICATE ISSUED BY YES
TAMILNADU GOVT.?
COMMUNITY BC
SUB CASTE KAMMALAR
ISSUING AUTHORITY OF COMMUNITY CERTIFICATE ZONAL DEPUTY TAHSILDAR
COMMUNITY CERTIFICATE NO CC7B6A6F6A687A86
COMMUNITY CERTIFICATE PLACE OF ISSUE NAMAKKAL
COMMUNITY CERTIFICATE ISSUING DATE 05-JAN-2015
ARE YOU DIFFERENTLY ABLED? NO
DATE OF BIRTH (AS PER SSLC MARK SHEET) 06-MAY-2004
AGE AS ON 01-07-2025 21 YEARS 1 MONTHS 25 DAYS
EMAIL ID ARUNAARUL490@[Link]
MOBILE NO 9342179515
WOULD YOU LIKE TO GIVE FATHER AND MOTHER FATHER AND MOTHER
NAME OR GUARDIAN NAME
FATHER'S NAME RAMAKRISHNAN R
MOTHER'S NAME PUSHPA R
ARE YOU MARRIED NO
NATIVITY NAMAKKAL - TAMIL NADU
GENDER FEMALE
RELIGION HINDU
ARE YOU ALREADY IN GOVERNMENT SERVICE? NO
PHOTO ID PROOF DETAILS
PHOTO ID PROOF VOTER ID
PHOTO ID PROOF NO. YAK2264125
PERMANENT ADDRESS
ADDRESS 32/49, SOUTH STREET, EAST THOTTIPALAYAM, KADACHANALLUR, NAMAKKAL
STATE TAMIL NADU
DISTRICT NAMAKKAL
CITY / VILLAGE NAMAKKAL
PINCODE 638008
CORRESPONDENCE ADDRESS
ADDRESS 518, SPB COLONY
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STATE TAMIL NADU
DISTRICT NAMAKKAL
CITY / VILLAGE NAMAKKAL
PINCODE 638008
MOTHER TONGUE
MOTHER TONGUE TAMIL
EDUCATIONAL QUALIFICATION
EXAMINATION NAME OF THE BOARD OTHER BOARD MONTH/YEAR OF MEDIUM OF HAVE YOU STUDIED
PASSING INSTRUCTION TAMIL AS ONE OF THE
LANGUAGE (PART-1)
10TH / SSLC TAMIL NADU STATE - MARCH 2019 TAMIL YES
BOARD
XII / HSC TAMIL NADU STATE - MAY 2021 TAMIL YES
BOARD
EXAMINAT DEGREE OTHER NAME MONTH/ RECOGNI MEDIUM ARE YOU DATE OF TAMIL REGISTR REGISTR
ION NAME EQUIVAL OF YEAR OF ZED OF A REGISTR NADU ATION ATION
ENT UNIVERS PASSING UNIVERS INSTRU REGISTE ATION PHARMAC CARD VALID
DEGREE ITY ITY YES/ CTION RED Y TYPE UPTO
NO PRACTIT COUNCIL
IONER NUMBER
WITHIN
THE
TAMIL
NADU
PHARMA
CY
COUNCIL
UNDER DIPLOMA - MGR NOVEMB YES ENGLIS YES 22- 76039A2 PERMAN -
GRADUATE IN UNIVERS ER 2023 H OCT-202 ENT
PHARMAC ITY 4 VALID
Y CARD
EXAMINATION DO YOU HAVE DEGREE SPECIALIZATION MONTH & YEAR OF PASSING
POST GRADUATE NO - -
PG DIPLOMA NO - -
ARE YOU ELIGIBLE TO AVAIL PSTM PREFERENCE? NO
COVID DUTY CERTIFICATE
HAVE YOU WORKED IN COVID PERIOD? NO
UPLOAD DOCUMENTS
DOCUMENT NAME FILE NAME
COMMUNITY CERTIFICATE ARUNA_COMMUNITY.PDF
SSLC CERTIFICATE ARUNA_10TH.PDF
HSC CERTIFICATE ARUNA_12TH.PDF
UG DEGREE CERTIFICATE ARUNA_DEGREE.PDF
TAMIL NADU PHARMACY COUNCIL REGISTRATION CERTIFICATE ARUNA_PHARMACYCERTIFICATE.PDF
DECLARATION
27-02-2025 [Link] 2
I HEREBY DECLARE THAT ALL THE PARTICULARS FURNISHED IN THIS APPLICATION ARE TRUE, CORRECT AND COMPLETE TO THE BEST OF
MY KNOWLEDGE AND BELIEVE. IN THE EVENT OF ANY INFORMATION BEING FOUND FALSE OR INCORRECT OR INELIGIBILITY BEING DETECTED
BEFORE OR AFTER THE SELECTION, ACTION CAN BE TAKEN AGAINST ME BY THE MRB.
I HEREBY DECLARE THAT I WILL NOT BE A PARTY TO ANY KIND OF CANVASSING ON MY BEHALF.
I FURTHER DECLARE THAT I FULFIL ALL THE ELIGIBILITY CONDITIONS PRESCRIBED FOR ADMISSION TO THIS POST.
I HAVE INFORMED MY EMPLOYER IN WRITING THAT I AM APPLYING FOR THIS POST AND FURNISH THE NOC FOR THIS PURPOSE (IF
APPLICABLE).
I HAVE GONE THROUGH THE INSTRUCTIONS ETC. TO CANDIDATES AND THE BOARDS NOTIFICATION FOR THIS RECRUITMENT, BEFORE
FILLING UP THE APPLICATION FORM AND I AM ELIGIBLE TO APPLY FOR THIS POST.
I DECLARE THAT I POSSESS THE MEDICAL STANDARDS PRESCRIBED FOR THE POST(S) WHICH I AM NOW APPLYING.
I CERTIFY THAT I HAVE NOT BEEN DEBARRED / DISQUALIFIED BY THE BOARD OR ANY OTHER RECRUITING AGENCY.
I AM NOT A DISMISSED GOVERNMENT EMPLOYEE.
THERE IS NO CRIMINAL CASE FILED AGAINST ME IN THE POLICE STATION / COURT.
THERE IS NO VIGILANCE CASE FILED AGAINST ME.
I HEREBY DECLARE THAT MY CHARACTER / ANTECEDENTS ARE SUITABLE FOR APPOINTMENT TO THIS POST.
I DECLARE THAT I DO NOT HAVE MORE THAN ONE LIVING SPOUSE.
☑ I ACCEPT THE ABOVE DECLARATION.
SUBMITTED DATE : 27-FEB-2025 (SIGNATURE OF THE CANDIDATE)
27-02-2025 [Link] 3
