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Application Form for Various Posts
Name of the Post Applied for
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Director of Research
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Permanent Address of Residence
City
State
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Maharashtra
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chhattisgarh
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Madhya Pradesh
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttarakhand
Uttar Pradesh
West Bengal
Gujarat
Delhi
Andaman and Nicobar Islands
Dadra and Nagar Haveli
Daman and Diu
Goa
Lakshadweep
Puducherry
Telangana
PIN code
Mobile Number
Phone Number
Adhar Card Number
Date of Birth
(enclose the mark sheet of high school examination or birth certificate in certificates section)
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Age of applicant as on 11.11.2023
Day
Month
Year
Applicant's Marital Status
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Married
Unmarried
Date of Marriage
Category
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General / Open Category
Scheduled Caste
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Disabled
Registration Number and Name of the Council and Date
Council
Name of Council
Registration Number
Registration Date
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UG
PG
Super Speciality
Educational Qualifications
(upload attested photo copies of certificates and marks sheets in certificates section)
Examination Name
Name of Degree
Board Name / University Name
Year
Subject
Marks Obtained
Total Percentage
Attempts
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UG
PG
Super Speciality
Ph.D.
Teaching Experience
(upload experience certificate in certificates section)
Designation
From Date
To Date
Duration
Institute Name
Research
Experience in Clinical Research
Experience in making Health Policies and Strategies
Experience regarding NAAC Accreditation pertaining to research
No. of International Publications
No. of National Publications
Scopus ID
Citation Index
H Index
Research Publications
(Attach Photo Copy in certificate section)
Designation
Research Publication (Title)
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Principal
Professor
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Assistant Professor
Any other relevant information/ experience related to the post.
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Particulars
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Certificates
List of attach certificates(.jpg/.png/.pdf format and maximum size 700KB)
Certificate Name
Certificate
1) I certify that the above information given by me is complete and true. In the event of information being false, my application form / appointment letter can be canceled.
2) I certify that I have not been found guilty by any court of any offense of moral decimation nor is there any such case against me in any jurisdiction.
Declaration:
I Agree
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