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Applicant Details

Personal Details

Application Sequence No
ESICP403682

Candidate's Name
A RENUKA

Father's Name Mother's Name

CHINNA MASAIAH A BALAMMA

Marital Status
Married

Nationality
a citizen of India
Post Applied

Post Applied Post Code

Staff Nurse 17

Preferred State/City of Posting Center Choice 1

Telangana Hyderabad

Center Choice 2 Center Choice 3

Warangal Karimnagar

Category Gender
SC Female

Date of Birth (DD-MM-YYYY) same as Matriculation/ Age as on 21.01.2019

Secondary Certificate
18/Jun/1983 35 Years 7 Months 3 Days

Are you Physically Handicapped (PH) (degree of disability Are you an Ex-Service man?
40% or above)? No
No

Were you originally domiciled in the state of Jammu and Are you a Government servant?
Kashmir between 01.01.1980 and 31.12.1989 ?
No
No

Are you an employee of ESIC? Any other category for relaxation in age
No Yes

Please mention the category

sc
Contact Details

Mobile Number Email ID

8125838913 pharmabioinfo@gmail.com

Present Address

Address Line 1
2-26 D. Dasratha house TUKKUGUDA MAHESWERAM RANGAREDDY DIST

Address Line 2
MANKHAL POST OFFICE

Country
India

State City
Telangana Adilabad

Pin Code
501359

Permanent Address

Address Line 1
A RENUKA W/O A THIRUPATHAIAH and c/o devadhanam house vattipalli village
 Address Line 2
post peddakothapally NAGARKURNOOL DIST

Country
India

State City
Telangana Other

Pin Code
509412

Matriculation (10th)/Equivalent Details

Name of the Board/Council

BOARD OF SECONDARY EDUCATION -SSC

Year Of Passing Subject Combination

1999 ENGLISH TELUGU MATHS SCIENCE SOCIAL
STUDIES HINDHI

% of Marks
54.1

Intermediate (12th)/Equivalent Details

Name of the Board/Council

BOARD OF INTERMEDIATE EDUCATION
 Year Of Passing Subject Combination
2001 ENGLISH TELUGU ECONOMICS COMMERCE
CIVICS

% of Marks
52.1

Diploma/UG Degree Details

Diploma/UG Course Name

Diploma Degree

Specialization Year Of Passing

General Nursing and Midwifery or equivalent 2005

Percentage of Marks
63

Previous Work Experience Details

Are you registered & qualified as pharmacist under Pharmacy Act, 1948 ?
Yes

Registration Number
RN49600 RM49414
Previous Work Experience Details (latest to earliest)

Sr. Designation/Post Organization/ From

No. Employer

1 STAFF NURSE SVS MEDICAL 08/0

COLLEGE
HOSPITAL
NRHMMMU
KVCRPF

Total Work Experience

10 Year(s), 10 Month(s)

Payment Details

Amount to be Paid
250

Beneficiary Name Banke Name

TEJASWINI INTERNET AND XEROX INDIAN BANK

Account Number IFSC Code

6444526988 IDIB000Y006

Candidate Documents/Images Upload Details

 Photo

Signature

Declaration

I hereby, solemnly declare that information provided by me in the form is true to the best of my
knowledge and belief. I understand that my candidature is subject to the conditions laid down in the
adverisement brochure. I further declare that I am not involved in any criminal case and/or no such
case is pending against me in any court of law.

Version 13.06.01