All India Institute Of Medical Sciences, New Delhi

Ansari Nagar, New Delhi - 110029

Common Recruitment Examination(CRE) 2024

Applicant Registration Form

Basic Details
Candidate id 8176128059 Application Date Jan 20, 2025

Applicant's name AMIT KUMAR Registration number 5418202262

Assistant(NS)/Assistant Administrative
Advertisement Number Notice No.171/2025 Applied Post in Group Officer/Executive Assistant(N.S)/Junior
Administrative Officer/Office Assistant(NS)

Group Code 2

Selected Qualification (s) / set (s) as applicable to make you eligible for the selected post as per the advertisement. (Your eligibility is subject to
verification as claimed here.)

Set no. Sets

Set 1 Degree from recognized University or its equivalent

PWBD No PWBD percentage N/A

PWBD Category N/A PWBD Sub Category N/A

Which facility do you require to appeare in the exam? N/A

Category as Notice regarding identification of Posts suitable

for PWBD see Section XVII- Annexure-V of Notice No-171/2025

Father's Name OM PARKASH Mother's Name RAJPATI

Category OBC Nationality Indian

Are you a Ex-

State of Domicile Haryana serviceman/Commissioned No
Officer(including ECO,SSCO)

Service Provided in (Name of Armed

N/A Service Start Date N/A
forces)

Service End Date N/A Length of service(In Days) N/A

Are You Regular Govt. Servant? Yes Name of Institution/Organization Education of Bihar

Type Of Organization State Government Type Of Job Status Regular

Present Position Held chemistry teacher Date Of Appointment From Feb 18, 2024

Till Date Jan 31, 2025 Length of service(In Days) 349

Are you Employee of Participating

AIIMS/Institute? No Type of Employement N/A

Name Of Institute N/A Date Of Appointment N/A

Till Date N/A Length of service(In Days) N/A

Marital status Unmarried Gender Male

Had you ordinarily been domiciled in the State of Jammu &

No
Kashmir?

Are you Service Clerks in the last year of their colour service
No
in the Armed Forces?

Are you Defence Personnel disabled in operation during

hostilities with any foreign country or in a disturbed area and No
released as a consequence thereof ?

Are you Widows/Divorced Women/Women judicially separated

N/A
and not remarried?

Date of Birth Nov 30, 1995

 ID Proof
Id Proof Id Proof Number

Aadhaar Card 593599022528

Contact Details
Alternate
Phone no E-mail id Postal address Permanent address
Number

1657/1 Rajendra colony,near state ware house 1657/1 Rajendra colony,near state ware house
9518011814 9466467217 [email protected]
Rohtak 124001, Rohtak, Haryana, India 124001 Rohtak 124001, Rohtak, Haryana, India 124001

Payment details
Mode Date Transaction id Amount

SBI Jan 21, 2025 B126682722487 3000

Educational Qualification
S. Name of the Place of Date of Obtain
Number Degree Subject/Discipline/Title University/Institute/College University/Institute/College Passing percentage Certificate

Bachelor of Jun 20,

1 Pharmacy Mdu Rohtak Mdu Rohtak 59.67
pharmacy 2018

Registration Details:
Registered as Registration No State Name Issuing Date of Registration Registering Authority Registering Certificate

N/A N/A N/A N/A N/A --

Experience Details
S. Organization Position Employee Currently Start End Nature Of Length of service(In
Certificate
Number Name Held Type Working Date Date Duties Days)

No Experience

Examination State Choice

# First Preference Second Preference Third Preference Fourth Preference

State Bihar Uttar Pradesh Delhi Any where in India

Certificates

No Objection Certificate -- Category Certificate

Category Certficate No. HA1600161388 Category Certficate Issue date Jun 24, 2014

PWBD Certificate -- PWBD Appendix A-1/A-2/A-3 Certificate --

Date Of Birth Certificate

UNDERTAKING/DECLARATION
I hereby declare:

(i) I understand that merely applying does not guarantee my candidature/ eligibility/ seelction, which will be subject to verification.

(ii) 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 then I shall be liable to civil/criminal prosecution and my claim to admission/appointment/registration/ service in the Institute may be
cancelled/terminated.

(iii)That I have read the Detailed Recruitment Advertisement and agree to abide by the terms and conditions.

(iv) That I authorize AIIMS, New Delhi to use my information provided in application for the purpose as decided by AIIMS, New Delhi including sharing with other
associated with recruitment process at the discretion of AIIMS, New Delhi.

Signature of Candidate Thumb of Candidate