Railway Recruitment Board - Online Registration

Online Registration CEN 02/2019 for Paramedical Categories

RRB SECUNDERABAD
PRINTED APPLICATION FORM

Registration
Number

2820035677
Name GUTTULA SURYAVATHI

Date of
04-05-1995 Gender FEMALE
Birth
Father's
GUTTULA BULLABBAI Mother's Name GUTTULA SATYAVATHI
Name
Matriculation /10th /SSLC Roll
1008117298
number
Year of Passing Matriculation /10th
2010
/SSLC
Mobile
9573120555 E-mail ID suryasiri1995@gmail.com
Number
Aadhaar
Card I have Aadhaar Card
Status
Aadhaar
Number /
Aadhaar 566092240603
Enrollment
Number
Community OBC (OTHER BACKWARD CLASS) - NON CREAMY LAYER
Nationality CITIZEN OF INDIA Religion HINDU
S.No. Applied Qualification
Bachelor degree in Pharmacy (B.Pharm) from a recognized University or equivalent and Registered as a Pharmacist under
1
the Pharmacy Act, 1948

Are you a Widow not re-married /Divorcee not re-married / Judicially Separated not
No
re-married?
Are you a person with Benchmark
No
Disabilities(PwBD)?
Are you an Ex - Serviceman? No
Were you domiciled in Jammu
and Kashmir during 1.1.1980 to No
31.12.1989?
Are you an employee in Central
Government/ State Government / No
Public Sector Unit?
Are you a Serving Group C or
erstwhile Group D Railway
No
Employee or Casual labour or
Substitutes?
Are you an employee in Quasi-
admiministrative offices of
Railway Organisation such as No
Railway canteens, co-operative
societies and institutes?

PAYMENT DETAILS

Payment Mode Merchant Reference No Transaction ID Transaction Amount

ONLINEPAY 28200356777 CPQ2830523 250.00

BANK DETAILS

Do you wish to receive the refund to the same account through which you made the payment? Yes

JOB PRIORITY DETAILS

S.No. Post Name(Rly/Prod.Unit) Order of Post Preference
1 PHARMACIST GRADE III (SCR) 1
2 PHARMACIST GRADE III (ECoR) 2

DETAILS OF ESSENTIAL QUALIFICATION

Name of the Exam State Year of Passing

SSLC/Matriculation -- 2010
12TH(10 +2) OR ITS EQUIVALENT Andhra Pradesh 2012

OTHER DETAILS
Mother Tongue Telugu
Choice of Language for Exam English

ADDRESS FOR THE COMMUNICATION

Address
9-175, KOTTA COLONY, SOMESWARAM VILLAGE
Line 1
Address
RAYAVARAM MANDALAM, EAST GODAVARI DISTRICT
Line 2
State Andhra Pradesh District East Godavari
Classification Village
City /
Town/ Ramachandrapuram Pincode 533261
Village

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