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 6952619319 Application Date Jan 24, 2025

Applicant's name RAHUL KUMAR Registration number 8511323708

GUPTA

Data Entry Operator Grade A/Junior Administrative

Advertisement Number Notice No.171/2025 Applied Post in Group Assistant/Lower Division Clerk/Senior
Administrative Assistant/UDC/Upper Division Clerk

Group Code 3

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 12th standard pass or equivalent

Set 2 Degree of recognized University or 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 JITTU SAW Mother's Name PANPATTI DEVI

Category OBC Nationality Indian

Are you a Ex-

State of Domicile Uttar Pradesh 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? No Name of Institution/Organization N/A

Type Of Organization N/A Type Of Job Status N/A

Present Position Held N/A Date Of Appointment From N/A

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

Are you Employee of Participating

No Type of Employement N/A
AIIMS/Institute?

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
N/A
separated and not remarried?

Date of Birth Dec 10, 1999

ID Proof
Id Proof Id Proof Number

Aadhaar Card 973416299812

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

S/O LATE SHRI JITTU SAW, SUSUWAHI NEAR S/O LATE SHRI JITTU SAW, SUSUWAHI NEAR
HYDERABAD GATE B.H.U. VARANASI, HYDERABAD GATE B.H.U. VARANASI,
6386081832 7458977521 [email protected] LANDMARK CHHOTI GATE B.H.U. LANDMARK CHHOTI GATE B.H.U.
SUSUWAHI, 221011, POLICE STATION SUSUWAHI, 221011, POLICE STATION
LANKA, VARANASI, U.P. INDIA, Varanasi, Uttar LANKA, VARANASI, U.P. INDIA, Varanasi, Uttar
Pradesh, India 221011 Pradesh, India 221011

Payment details
Mode Date Transaction id Amount

SBI Jan 24, 2025 B632535768125 3000

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

Bachelor of BANARAS HINDU Jun 28,

1 AIHC & Archaeology VARANASI 81.2
Arts (Hons.) UNIVERSITY 2023

10+2
Physics, Chemistry, Math, K.V.N. PUBLIC SCHOOL / May 28,
2 Intermediate VARANASI 63.2
English, Physical Education C.B.S.E 2017
Exam

10th Matric Hindi, English, Math, Navneeta Kunwar Public May 28,
3 VARANASI 70.3
Exam Science, Social Science School / C.B.S.E 2015

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 Uttar Pradesh Delhi Madhya Pradesh Any where in India

Certificates

No Objection Certificate -- Category Certificate

Category Certficate No. 672213005439 Category Certficate Issue date Jan 31, 2021

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