performa to be filled by gst tr(overview)

1.) PERSONAL DETAILS Name* *(Max. 50 Characters) Father's Name* *(Max. 50 Characters) Mother's Name* *(Max. 50 Characters) Date of Birth* **  (dd/mm/yyyy) Gender* ... Male Female* Category* ... BC General SC ST* Caste* *(Max. 50 Characters) B.) POST DETAILS Post Held* ... JBT Head Teacher* Subject Name / Stream* *(Max. 50 Characters) School Code where working*(Click here for School Code) *(Max. 6 Characters) PAN Number* *(Max. 10 Characters) D.) SERVICE DETAILS S.No. School Code(Click here for School Code) Start Date End Date 1.) (Max. 6 Characters) *(dd/mm/yyyy) *(dd/mm/yyyy) 2.) (Max. 6 Characters) *(dd/mm/yyyy) *(dd/mm/yyyy) 3.) (Max. 6 Characters) *(dd/mm/yyyy) *(dd/mm/yyyy) 4.) (Max. 6 Characters) *(dd/mm/yyyy) *(dd/mm/yyyy) 5.) (Max. 6 Characters) *(dd/mm/yyyy) *(dd/mm/yyyy) 6.) (Max. 6 Characters) *(dd/mm/yyyy) *(dd/mm/yyyy) E.) QUALIFICATION Title Class Name / Qualification Passing Year Roll Number University / Board Marks Obtained Total Marks Matric* ... Matric (Regular) * ... 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* * * * ** XII* ... XII (Non-Med) XII (Med) XII (Arts) XII (Commerce) XII (Other) Prep. JBT(Without XII)* ... 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* * * * ** Professional Qual.* ... D.Ed JBT Cert. In Teaching Parbhakar* ... 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011* * * * ** Graduation ... B.A BCA B.Com B.Sc ... 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 * Post Graduation ... M.A. M.Com M.Sc MCA ... 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 * Other Qualification ... B.Ed M.Ed Parbhakar(After JBT) ... 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 * F.) OTHER DETAILS (a.) Is P.hD passed/qualified (Tick if Yes) No Yes If yes, give P.hD Passing Year (Max. 4 Digits) (b.) Is STET passed/qualified (Tick if Yes) No Yes If yes, give STET details. S.No. Subject Roll Number Year 1.) (Max. 50 Characters) (Max. 10 Characters) (Max. 4 Digits) (c.) Are you married? (Tick if Yes) No Yes If yes, give Spouse details. S.No. Name Profession Place of Work/Department Name Government 1.) ... Government Private Self Employeed Other (d.) Is medical case? (Tick if Yes) No Yes If Yes, give Medical Case details. S.No. Name of Member who suffering with chronic disease Relation Name of disease Name of Hospital issuing medical certificate Date since suffering with the disease (dd/mm/yyyy) 1.) ... Self Brother Sister Father Mother Grand Father Grand Mother Son Daughter * G.) ADDRESS Permanent Address* * Correspondence Address* * Tehsil* * Tehsil* * District* * District* * Pin Code* (6 digit code) * Pin Code* (6 digit code) * Telephone Number* * Telephone Number* * Email Address * Click for Correspondence Address Same As Permanent Address
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