All India Institute of Medical Sciences (AIIMS) Bhubaneswar
(A statutory body under the aegis of Ministry of Health and Family Welfare, GOI)
Sijua, Post :Dumuduma, Bhubaneswar (Odisha) 751 019
Web site: www.aiimsbhubaneswar.edu.in
APPLICATION FORM
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Advertisement No. |
Please attach recent passport size photo |
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Name of the post |
Personal Details (in Block Letters)
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1. Full Name |
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2. Fathers Name |
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3. Address for Correspondence |
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4. Permanent Address |
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5. E-mail Id (In capital letters) |
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6. Phone/Cell No.1 |
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Phone/Cell No.2 |
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Land Line No. |
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7. Date of Birth (Please attach document for evidence) |
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D |
M |
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Y |
Y |
Y |
Y |
8. Nationality |
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9. Name of the State to which you belongs |
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10. Category |
UR |
OBC |
SC |
ST |
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11. If Physically Challenged (OPH Category) Percentage Disability |
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12. Details of Educational Qualifications |
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Examination Passed |
University/Board/Institution/Council of examination |
Month, Year of Passing |
No. of Extra Attempts |
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Secondary (10th ) |
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Senior Secondary(12th ) |
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MBBS / BDS |
Details of work experience:
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13. Name of the Organisation |
Period of Service |
Designation |
Nature of Duties performed |
Total Monthly Emoluments |
Reason for leaving Services |
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FROM |
TO |
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M |
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Y |
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Y |
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14. Bring the original and 02 sets of attested photocopies of related documents at the time joining.
15. Details of Application Fee: NEFT UTR No. ______________________ Date_____________ Amount Rs.__________.
16. I hereby declare that entries made in this form as above are true and correct to the best of my knowledge and belief. In the event of any information being found false/incorrect my candidature/ services are liable to be terminated without any notice. I______________________________________ agree to abide by the terms and conditions of contractual appointment (Appendix A of Advertisement).
Place:
Date: Signature of the Candidate
Important Dates
| Start Date | End Date | |
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| Notification Issued | 07-Mar-2017 | |
| Interviews | 04-Apr-2017 |
Notification Issued By
- Organization : All India Institute Of Medical Sciences
- Organization City, State : bhubaneswar, odisha
- Organization Website : http://www.aiimsbhubaneswar.edu.in
- Notification
- General Information
- Important Dates
- How To Apply
- Applications
- Exam Fees
- Eligibility
- Educational Qualifications
- Age Limits
- Reservations
- Posts / Positions / Services
- Job Vacancies List
- Examination Centres
- Plan Of Examination
- Exam Syllabus
- Exam Instructions
- Previous Question Papers
- Interview Questions
- Interview Experience
- Results