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RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS.pdf

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Sahil Ponia
Sahil Ponia

1. The document is an online registration form for recruitment of Group C paramedical posts by the Employees' State Insurance Corporation (ESIC). 2. It contains details submitted by the applicant Jahar Singh for the post of OT Assistant in Delhi NCR, including personal details, qualifications, work experience, language proficiency, and document uploads. 3. Upon completion, the applicant declares that all information provided is true and correct, and understands that false information could result in cancellation of candidature.

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10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 1/4 Registration Number : 258122280 Full Name : JAHAR SINGH Post : OT Assistant Region : Delhi NCR Category : OBC Are you a person with benchmark disability of 40% and above ? : NO Disability category : - Type of Disability : - Do you need compensatory time at the time of examination? : - Are you suffering from cerebral palsy and your writing speed is affected? : - If Yes, Do you need compensatory time at the time of examination? : - Whether your dominant (Writing) hand is affected? : - If Yes, Do you need compensatory time at the time of examination? : - Do you intend to use the services of a scribe ? : - Are you a person with specified disability covered under the definition of sec 2(s) of the RPwD Act, 2016 and not covered under sec 2(r) of the said act and having difficulty in writing? : NO If Yes, Do you need compensatory time at the time of examination? : - Are you a person with specified disability covered under the definition of sec 2(s) of the RPwD Act, 2016 and not covered under sec 2(r) of the said act and wish to avail the services of Scribe? : - I certify that, I will produce the certificate from competent medical authority of a Government healthcare institution as per Ministry of Social Justice and Empowerment, Department of Empowerment of Persons with Disabilities (Divyangjan) circular no F. No. 29-6/2019-DD-III dated 10.08.2022. : - Whether scribe will be brought by candidate ? : - Do you need scribe from Employees’ State Insurance Corporation ? : - EMPLOYEES’ STATE INSURANCE CORPORATION RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS 300130
10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 2/4 Do you belong to Religious Minority ? : NO Are you ESIC Employee/ Government Servant who have rendered not less than 3 years regular and continuous service as on closing date for receipt of application : ? : NO Kindly Specify : - Are you a regular ESIC employee seeking relaxation in fee ? : - Are you an Ex-Serviceman : ? : NO Period of Service ( in months) : - Ex-Servicemen who have already secured employment in civil side under Government in Group ‘C’ & ‘D’ posts on regular basis after availing of the benefits of reservation given to ex-servicemen : - Any other category for relaxation in age : NO Mention category for age relaxation : - Nationality : Indian State/UT to which centre of Online examination belongs : Uttar Pradesh Centre of Online Examination : Agra Application Fee / Intimation charges Payment In : ONLINE Amount : 500.00 Payment Status : PAID Reference ID : YHMP2127939980 Transaction Date : 30-10-2023 Do you want to receive refund of fees in the same channel by which you are paying fees ? : - Account Number : - Account Type : - Bank Name : - Branch Name : - IFSC Code : - Name of the Account Holder : - Personal Details Date of Birth : 10-05-1995 Age completed as on 30.10.2023 : 28 Gender : MALE Do you have twin brother / sister ? : NO Name of the twin : - Gender of the twin : - Marital Status : Married Father's Name : BADSHAH Mother's Name : SHANTI DEVI Spouse's Name : CHANDRAVATI
10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 3/4 Address for Correspondence Address 1 : MOHAN PUR KUTUKPUR Address 2 : QUTUKPUR Address 3 : ROHAI District : AGRA State : UTTAR PRADESH Pincode : 283125 Permanent address Address 1 : MOHAN PUR KUTUKPUR Address 2 : QUTUKPUR Address 3 : ROHAI District : AGRA State : UTTAR PRADESH Pincode : 283125 Contact Details Mobile No : +91 9756397535 Alternative Number (Mobile No/Landline No) : - Email ID : jaharskh2@gmail.com Educational Qualification (as on 30.10.2023) Exam Passed Degree/ Subject / Stream Duration of Course (in years) Date of Passing % of Marks Class / Grade Matriculation/10th SCIENCE - 10-06-2011 53.33 Second Class HSC/12th or Equivalent Science - 05-06-2013 60.20 First Class Do you have one-year experience in O.T. of a recognized Hospital? : YES Post Qualification Work Experience details as on 30.10.2023 (Start from present Employer) Name of the Employer Designation Total Period of Service From To Nature of Duties Reason of leaving Years of Experience (YY/MM/DD) Presently working? : YES SHREE KRISHNA HOSP ITAL OT TECHNICIAN 01/01/2016 30/10/2023 OT TECHNICIAN - 7/9/30 Total Experience in months : 94
10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 4/4 Languages Known Read Write Speak HINDI YES YES YES ENGLISH YES YES YES 1. Left Thumb Impression 2. Hand Written Declaration Other Details : Uploaded Document Details : Declaration: I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements, my candidature/appointment is liable to be cancelled/terminated. Date: 30-10-2023 Left Thumb Impression Hand Written Declaration

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RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS.pdf

  • 1. 10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 1/4 Registration Number : 258122280 Full Name : JAHAR SINGH Post : OT Assistant Region : Delhi NCR Category : OBC Are you a person with benchmark disability of 40% and above ? : NO Disability category : - Type of Disability : - Do you need compensatory time at the time of examination? : - Are you suffering from cerebral palsy and your writing speed is affected? : - If Yes, Do you need compensatory time at the time of examination? : - Whether your dominant (Writing) hand is affected? : - If Yes, Do you need compensatory time at the time of examination? : - Do you intend to use the services of a scribe ? : - Are you a person with specified disability covered under the definition of sec 2(s) of the RPwD Act, 2016 and not covered under sec 2(r) of the said act and having difficulty in writing? : NO If Yes, Do you need compensatory time at the time of examination? : - Are you a person with specified disability covered under the definition of sec 2(s) of the RPwD Act, 2016 and not covered under sec 2(r) of the said act and wish to avail the services of Scribe? : - I certify that, I will produce the certificate from competent medical authority of a Government healthcare institution as per Ministry of Social Justice and Empowerment, Department of Empowerment of Persons with Disabilities (Divyangjan) circular no F. No. 29-6/2019-DD-III dated 10.08.2022. : - Whether scribe will be brought by candidate ? : - Do you need scribe from Employees’ State Insurance Corporation ? : - EMPLOYEES’ STATE INSURANCE CORPORATION RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS 300130
  • 2. 10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 2/4 Do you belong to Religious Minority ? : NO Are you ESIC Employee/ Government Servant who have rendered not less than 3 years regular and continuous service as on closing date for receipt of application : ? : NO Kindly Specify : - Are you a regular ESIC employee seeking relaxation in fee ? : - Are you an Ex-Serviceman : ? : NO Period of Service ( in months) : - Ex-Servicemen who have already secured employment in civil side under Government in Group ‘C’ & ‘D’ posts on regular basis after availing of the benefits of reservation given to ex-servicemen : - Any other category for relaxation in age : NO Mention category for age relaxation : - Nationality : Indian State/UT to which centre of Online examination belongs : Uttar Pradesh Centre of Online Examination : Agra Application Fee / Intimation charges Payment In : ONLINE Amount : 500.00 Payment Status : PAID Reference ID : YHMP2127939980 Transaction Date : 30-10-2023 Do you want to receive refund of fees in the same channel by which you are paying fees ? : - Account Number : - Account Type : - Bank Name : - Branch Name : - IFSC Code : - Name of the Account Holder : - Personal Details Date of Birth : 10-05-1995 Age completed as on 30.10.2023 : 28 Gender : MALE Do you have twin brother / sister ? : NO Name of the twin : - Gender of the twin : - Marital Status : Married Father's Name : BADSHAH Mother's Name : SHANTI DEVI Spouse's Name : CHANDRAVATI
  • 3. 10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 3/4 Address for Correspondence Address 1 : MOHAN PUR KUTUKPUR Address 2 : QUTUKPUR Address 3 : ROHAI District : AGRA State : UTTAR PRADESH Pincode : 283125 Permanent address Address 1 : MOHAN PUR KUTUKPUR Address 2 : QUTUKPUR Address 3 : ROHAI District : AGRA State : UTTAR PRADESH Pincode : 283125 Contact Details Mobile No : +91 9756397535 Alternative Number (Mobile No/Landline No) : - Email ID : jaharskh2@gmail.com Educational Qualification (as on 30.10.2023) Exam Passed Degree/ Subject / Stream Duration of Course (in years) Date of Passing % of Marks Class / Grade Matriculation/10th SCIENCE - 10-06-2011 53.33 Second Class HSC/12th or Equivalent Science - 05-06-2013 60.20 First Class Do you have one-year experience in O.T. of a recognized Hospital? : YES Post Qualification Work Experience details as on 30.10.2023 (Start from present Employer) Name of the Employer Designation Total Period of Service From To Nature of Duties Reason of leaving Years of Experience (YY/MM/DD) Presently working? : YES SHREE KRISHNA HOSP ITAL OT TECHNICIAN 01/01/2016 30/10/2023 OT TECHNICIAN - 7/9/30 Total Experience in months : 94
  • 4. 10/30/23, 7:18 PM RECRUITMENT OF GROUP ‘C’ PARAMEDICAL POSTS https://ibpsonline.ibps.in/esicjan23/registration_print.php?q=ZjA4NzVmYmNiOTNlMDBmZTZiMGQwYWIyYzM1Y2RiZTl8MjU4MTIyMjgw# 4/4 Languages Known Read Write Speak HINDI YES YES YES ENGLISH YES YES YES 1. Left Thumb Impression 2. Hand Written Declaration Other Details : Uploaded Document Details : Declaration: I hereby declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility criteria according to the requirements, my candidature/appointment is liable to be cancelled/terminated. Date: 30-10-2023 Left Thumb Impression Hand Written Declaration