10/31/2019 CCRAS Form 2019

NOTE : Your Application has submitted Successfully.Payment is done.

Applicant Details

Personal Details

Application Sequence No
CCRAS19011329

Candidate's Name

RATAN YADAV

Father's Name Mother's Name

SUBE SINGH YADAV MEWA DEVI

Marital Status Nationality

Married Indian

Post Applied Details

Post Group Post Applied

Group B Posts Staff Nurse

Post Code Center Choice 1

18 Jaipur

https://cdn.digialm.com/EForms/loginAction.do?subAction=DisplayProfileAfterLogin&orgId=1258&p_orgId_formId_decrypt=1258&formId=61409&… 1/6
10/31/2019 CCRAS Form 2019

Center Choice 2 Center Choice 3

Delhi/NCR Chandigarh

Category Gender

UR Male

Date of Birth (DD-MM-YYYY) same as Matriculation/ Age as on 01.01.2019

Secondary Certificate
15/Jul/1995 23 Years 5 Months 17 Days

Are you Person with disability (PWD) (degree of

disability 40% or above)?

No

Are you an Ex-Service man? Were you originally domiciled in the state of Jammu
and Kashmir between 01.01.1980 and 31.12.1989 ?
No
No

Are you a Departmental Candidate?

No

Are you Central Government civilian employee having Are you a sportsperson eligible for age relaxation(as
three years of continuous service ? per GI,DOPT,O.M No 14034/1/91)?

No No

Contact Details

Mobile Number Email ID

7014018782 ratanyadav045@gmail.com

Present Address

Address Line 1
village -Nangal mehta,Post-kanhawas Tehsil-Neemrana

https://cdn.digialm.com/EForms/loginAction.do?subAction=DisplayProfileAfterLogin&orgId=1258&p_orgId_formId_decrypt=1258&formId=61409&… 2/6
10/31/2019 CCRAS Form 2019

Address Line 2

Village-Nangal mehta ,post -kanhawas , Teshsil- Neemrana Distt-Alwar

Country

India

State District

Rajasthan Alwar

Pin Code

301703

Permanent Address

Address Line 1

Vill-Nangal mehta, Post-Kanhawas Tehsil -Neemrana Distt. -Alwar Pin-301703

Address Line 2

Village-Nangal mehta ,post -kanhawas , Teshsil- Neemrana Distt-Alwar

Country

India

State District

Rajasthan Alwar

Pin Code

301703

Matriculation (10th) Details

https://cdn.digialm.com/EForms/loginAction.do?subAction=DisplayProfileAfterLogin&orgId=1258&p_orgId_formId_decrypt=1258&formId=61409&… 3/6
10/31/2019 CCRAS Form 2019

Name of the Board/Council

C.B.S.E

Year Of Passing Subject Combination

2010 ALL

Percentage of Marks

64.60

Intermediate (12th) Details

Name of the Board/Council

C.B.S.E

Year Of Passing Subject Combination

2012 ALL

Percentage of Marks

63.20

Do you have Diploma in General Nursing & Midwifery

recognised by Nursing Council of India

Yes

Bachelor/Graduate Degree Details

Degree Name

B.Sc.

Specialization Year of Passing

https://cdn.digialm.com/EForms/loginAction.do?subAction=DisplayProfileAfterLogin&orgId=1258&p_orgId_formId_decrypt=1258&formId=61409&… 4/6
10/31/2019 CCRAS Form 2019

Nursing 2018

Percentage of Marks

64

Previous Work Experience Details

Have you registered with the State Nursing Council ?

Yes

Payment Details

Amount

500

Payment Transaction No.

CPV8499773

Candidate Documents/Images Upload Details

Photo

Signature
Declaration

https://cdn.digialm.com/EForms/loginAction.do?subAction=DisplayProfileAfterLogin&orgId=1258&p_orgId_formId_decrypt=1258&formId=61409&… 5/6
10/31/2019 CCRAS Form 2019

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 13.07.01

https://cdn.digialm.com/EForms/loginAction.do?subAction=DisplayProfileAfterLogin&orgId=1258&p_orgId_formId_decrypt=1258&formId=61409&… 6/6