Himanchal Pradesh: Community Health Officer, 2021
Personal Details
Aadhaar Number
*
Full Name
*
(as in 10th document)
Father's Name
*
Category
*
Select
Un-Reserver (UR)
Other Backward Caste (OBC)
Scheduled Caste (SC)
Scheduled Tribes(ST)
eMail
*
Mobile Number
*
Date of Birth
*
Gender
*
Select
Male
Female
Other
Belong to EWS Category?
*
Select
Yes
No
Ward of Freedom Fighter?
*
Select
Yes
No
Belong to IRDP Category?
*
Select
Yes
No
Bonafide resident of Himachal Pradesh?
*
Select
Yes
No
Address
Permanent Address and Correspondence Address are same ?
Yes
No
Correspondence Address
*
Address Line 1
Address Line 2
*
City
*
Pin Code
*
District
*
State
Choose
Andaman and Nicobar
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhatisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshwadeep
Ladakh
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Telangana
Uttarakhand
Uttar Pradesh
West Bengal
Permanent Address
*
Address Line 1
Address Line 2
*
City
*
Pin Code
*
District
*
State
Choose
Andaman and Nicobar
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhatisgarh
Dadra and Nagar Haveli
Daman and Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu and Kashmir
Jharkhand
Karnataka
Kerala
Lakshwadeep
Ladakh
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Odisha
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Telangana
Uttarakhand
Uttar Pradesh
West Bengal
Education Qualification
Degree/Certificate
Completed
Name of the course completed
University/Board
Year of Passing
Percentage
B.Sc. Nursing /Post basic B.Sc. Nursing
Select
Yes
No
Integrated Course of Mid Level Health Provider
Select
Yes
No
Bridge Programme for Certificate in Community Health (BPCCH) Course certified by IGNOU
Select
Yes
No
Senior Secondary Education (+2)
Select
Yes
No
Secondary Education (Matriculation)
Select
Yes
No
Other Essentials Required Details
*
Do you have any working experience as CHO in Health Wellness Centre -Health Sub Centre
Select
Yes
No
Months (in figure)
Name of the Health Wellness Centre -Health Sub Centre, where deployed
DECLARATION:
I declare that the above information declared/ furnished by me are true and correct to the best of my knowledge and belief. I am aware that if at any point of time, the information furnished by me are found to be incorrect or false, my candidature is liable to be rejected in the selection process.