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Applicant Details
Personal Details
Application Sequence No
ESICP403682
Candidate's Name
A RENUKA
Marital Status
Married
Nationality
a citizen of India
Post Applied
Category Gender
SC Female
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
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
% of Marks
54.1
% of Marks
52.1
Percentage of Marks
63
Are you registered & qualified as pharmacist under Pharmacy Act, 1948 ?
Yes
Registration Number
RN49600 RM49414
Previous Work Experience Details (latest to earliest)
Payment Details
Amount to be Paid
250
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