Emp.Notification :*
Post Code :*
Demand Draft Number : Demand Draft Date : Name of the Banker :
Full Name:*   Father/Husband's Name:*
Date of Birth : *
Gender : Category Applied for :*
Are You a Person with Disability :
Have you Worked in ICMR Projects :
Are You a Govt Working in(State/Central/Semi-govt) :
Are You a Ex-Serviceman Service :
Do You Want Age Relaxation :
Martial status :
Select Identity proof type and fill ID Card Number :*   
Address :
Address1:* (H.No./Q.No./Ward): Address2:*
Post Office:* District:*
Pin Code:* State:
Permanent Address:
Address1:* (H.No./Q.No./Ward)
Post Office:*
Pin Code:*
Mobile Number:* Email-Id:*
Academic Qualifications(s)*
Name of the Examination/ Degree/Deploma Obtained Name of the Education Board/University Year of passing Division Details of Marks Percentage(%) Subject(s) Taken
Total Obtained
Any Additional Qualification:
(Technical and desirable qualification
may be mentioned here)
Computer Knowledge:
(Specify degree/diploma obtained
and/or any experiences of using Computer)
Language Known:*
Employment History*
Name of Employer Period Experience in Years Catogery Designation Last Salary Drawn (in Rs. ) Nature of Work Remarks
From To
Award & Scholarship:
(If any)
Research Experience:
(Specify point wise)
Details of Postgraduate Work & Published Papers:
(Give titles of paper published
and enclosed reprints)
Secure Code:*
Photo Upload:*  


I hereby declare that all the statements made in my application and the attached job application form are true, complete and correct to the best of my knowledge and belief. In the event of any information being found false or incorrect at any stage, my application is liable to be rejected and if already appointed, my services are liable to be terminated without notice.

Place: Sign Upload:*
Date: Signature of the Candidate: