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Premlata, a female OBC candidate from Chhattisgarh, applied for the Nursing Officer Recruitment Common Eligibility Test (NORCET-4) on April 26, 2023. She completed her B.Sc. in Nursing from Govt. College of Nursing Durg, Chhattisgarh in 2019. Her registration numbers with the Chhattisgarh Nursing Council are XXVI-12573 for both Nurse and Midwife. She opted to take the exam in Bilaspur, Chhattisgarh as her first preference and Raipur as her second preference.

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Bhupendra Yadav
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623 views

Aiims Form PDF

Premlata, a female OBC candidate from Chhattisgarh, applied for the Nursing Officer Recruitment Common Eligibility Test (NORCET-4) on April 26, 2023. She completed her B.Sc. in Nursing from Govt. College of Nursing Durg, Chhattisgarh in 2019. Her registration numbers with the Chhattisgarh Nursing Council are XXVI-12573 for both Nurse and Midwife. She opted to take the exam in Bilaspur, Chhattisgarh as her first preference and Raipur as her second preference.

Uploaded by

Bhupendra Yadav
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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4/26/23, 11:04 AM https://norcet4.aiimsexams.ac.

in/RegistrationSlip

All India Institute of Medical Sciences


Ansari Nagar, New Delhi - 110608
APPLICATION FORM - Nursing Officer Recruitment Common Eligibility Test (NORCET-4)

Candidate Profile Candidate ID: 6141251744 Registration No: 52051912 Registration Date: 26/04/2023

Candidate Name: PREMLATA Date of Birth: 23 Jul 1996

Gender: Female Category: OBC (NCL)

Father's Name: UMASHANKAR Mother's Name: GURUWARIN BAI

Persons with Benchmark Disability Status: No PWBD Category: NA

Nationality: INDIAN State of Domicile: CHATTISGARH

Applied for :
Nursing Officer Recruitment Common Eligibility Test (NORCET-4)

Are you a Government Employee : No

Are you a Ex-Service men : No

Contact Details

Address for Permanent: Correspondence Address:


C/O UMASHANKAR YADAV ,HOUSE NO.- 0051 BANKI MONGRA C/O UMASHANKAR YADAV ,HOUSE NO.- 0051 BANKI MONGRA KORAI ., , ,
KORAI ., , , Banki Mongra , CHATTISGARH, India, 495447 Banki Mongra , CHATTISGARH, India, 495447

Mobile No: 1. 7000048742 ,        2. No E-Mail ID: [email protected]

Qualification Details

Qualifying Exam University Name Collage Name Admission Passing


Date Date

B.Sc (Hons.) Nursing / B.Sc Nursing from an Indian PT. D. U.M. H. S. AND AYUSH GOVT. COLLEGE OF 10/11/2014 16/03/2019
Nursing Council recognized Institute or University UNIVERSITY OF CG. NURSING DURG CG.

Registration Number with Nursing Council of India/State Nursing Council

Registered as Registration No:(Nurse) Registration No.: (Midwife) State Name of Nursing Council: Issuing Date of Registration:

Nurse and Midwife XXVI-12573 XXVI-12573 CHATTISGARH 05/07/2019

Valid Photo Identity (To be presented in original at the Examination Center along with Admit Card)

ID Proof: Adhar Card ID No: 640762342484 Place of Issue: INDIA Issue Date: NA Valid Till: NA

Payment Details

Mode: Online Date: 26/04/2023 Transaction ID: 12517441193 Amount: 3000

Do you have experience : No

Examination City Opted:


State: Exam City (Preference 1): State : Exam City (Preference State : Exam City (Preference 3):
CHHATTISGARH BILASPUR (CG) CHHATTISGARH 2): RAIPUR CHHATTISGARH BHILAI NAGAR/DURG

UNDERTAKING/DECLARATION: I hereby declare that the information furnished by me in the Registration/Application Form is correct and nothing has been
concealed. In case any information furnished by me is found to be false/incorrect/untrue than i shall be liable to civil/criminal prosecution and my claim to
admission/appointment/registration/ service in the Institute may be cancelled/terminated.

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Signature of Candidate
Thumb of Candidate

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