ONLINE APPLICATION REGISTRATION FOR LABORATORY TECHNICIAN GRADE - II
(TNMSS) 2025
USER ID MRBLTG2MW25003291
POST APPLYING FOR LABORATORY TECHNICIAN GRADE - II (TNMSS)
PERSONAL DETAILS
NAME NANTHINI
NATIONALITY INDIAN
GENDER FEMALE
ARE YOU AN EX-SERVICEMEN NO
DO YOU HAVE COMMUNITY CERTIFICATE ISSUED YES
BY TAMIL NADU GOVERNMENT?
COMMUNITY SC
SUB CASTE ADIDRAVIDA
ISSUING AUTHORITY OF COMMUNITY CERTIFICATE YES
COMMUNITY CERTIFICATE NUMBER 7368799
COMMUNITY CERTIFICATE PLACE OF ISSUE THIRUCHENDUR
COMMUNITY CERTIFICATE ISSUING DATE 06-NOV-2021
ARE YOU DIFFERENTLY ABLED? NO
DATE OF BIRTH (AS PER SSLC MARK SHEET) 18-FEB-2000
AGE AS ON 01-07-2025 25 YEARS 4 MONTHS 13 DAYS
EMAIL ID NANTHININANTHINI1802000@[Link]
MOBILE NUMBER 9361294514
WOULD YOU LIKE TO GIVE FATHER AND MOTHER FATHER AND MOTHER
NAME OR GUARDIAN NAME
FATHER'S NAME VIJAYAN
MOTHER'S NAME RATHI
ARE YOU MARRIED? YES
NAME OF SPOUSE SURYA BALA
NATIVITY THOOTHUKUDI - TAMIL NADU
RELIGION HINDU
ARE YOU ALREADY IN GOVERNMENT SERVICE? NO
PHOTO ID PROOF DETAILS
PHOTO ID PROOF VOTER ID
PHOTO ID PROOF NUMBER AXX1297589
PERMANENT ADDRESS
ADDRESS 976,1ST FLOOR,DR. AMBEDKAR NAGAR , ADAMBAKKAM
STATE TAMIL NADU
DISTRICT CHENNAI
CITY / VILLAGE ADAMBAKKAM
PINCODE 600088
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CORRESPONDENCE ADDRESS
ADDRESS 976,1ST FLOOR,DR. AMBEDKAR NAGAR , ADAMBAKKAM
STATE TAMIL NADU
DISTRICT CHENNAI
CITY / VILLAGE ADAMBAKKAM
PINCODE 600088
MOTHER TONGUE
MOTHER TONGUE TAMIL
EDUCATIONAL QUALIFICATION
EXAMINATION NAME OF MONTH & TOTAL TOTAL PERCENTAGE MEDIUM OF CERTIFICATE HAVE YOU
BOARD YEAR OF MAXIMUM OBTAINED OF MARKS INSTRUCTION ISSUED DATE STUDIED
PASSING MARKS MARKS TAMIL AS
ONE OF
THE
LANGUAGE
(PART-1)
10TH / SSLC TAMIL NADU MAY 2015 500 416 83.20 TAMIL 21-MAY-2015 YES
STATE BOARD
12TH / HSC TAMIL NADU MAY 2017 1200 840 70.00 TAMIL 12-MAY-2017 YES
STATE BOARD
EXAM DIPLOM OTHER PERIOD PERIOD DURAT NAME MONTH DO TOTAL TOTAL PERCE MEDI CERTIF HAVE
INATI A/ OF OF ION OF OF & YOU MAXIM OBTAI NTAGE UM ICATE YOU
ON CERTIF EQUIV STUDY STUDY STUDY INSTI YEAR HAVE UM NED OF OF ISSUED STUDI
ICATE ALENT FROM TO (NUMB TUTIO OF MARKS MARKS MARKS MARKS INSTR DATE ED
COURS ER OF N PASSIN FOR UCTIO TAMIL
E DIPLO YEARS) G THE N AS
NAME MA / DIPLOM ONE
CERTI A/ OF
FICAT CERTIF THE
E ICATE LANG
COUR COURS UAGE
SE E? (PART-
1)
DIPLO DIPLO - 2017 2019 2 GOVT JANUA YES 450 299 66.44 ENGL 21- NO
MA / MA IN THOO RY ISH DEC-20
CERTI MEDIC THUKU 2020 21
FICAT AL DI
E LABOR MEDIC
COUR ATORY AL
SE TECHN COLL
OLOGY EGE
COURS
E
(TWO
YEARS
DURAT
ION)
OTHER QUALIFICATION
DO YOU HAVE ANY OTHER QUALIFICATION? NO
UPLOAD DOCUMENTS
DOCUMENT NAME FILE NAME
COMMUNITY CERTIFICATE [Link]
SSLC CERTIFICATE [Link]
HSC CERTIFICATE [Link]
DIPLOMA / CERTIFICATE COURSE CERTIFICATE [Link]
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DOCUMENT NAME FILE NAME
DIPLOMA / CERTIFICATE COURSE MARKSHEET [Link]
DECLARATION
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 BOARD'S 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 AM UNMARRIED.
☑ I ACCEPT THE ABOVE DECLARATION.
SUBMITTED DATE : 28-JUL-2025 (SIGNATURE OF THE CANDIDATE)
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