नाम / Name*
[Note 1 : Please do not use any prefix such as Shri/ Mr./ Ms./ Dr./ Mrs. Etc.]
पिता का नाम / Father's Name
[Note 1 : Please do not use any prefix such as Shri/ Mr./ Dr. Etc.]Note 2 : Candidate who has single parent may fill either Mother's Name or Father's Name in both the fields.]
माता का नाम / Mother's Name
[Note 1 : Please do not use any prefix such as Shri/ Mr./ Dr. Etc.]Note 2 : Candidate who has single parent may fill either Mother's Name or Father's Name in both the fields.]
लिंग / Gender*
Male
Female
Others
समुदाय / Community*
40% या अधिक विकलांगता के साथ बेंचमार्क विकलांगता वाले उम्मीदवार / Candidate of Persons with Benchmark Disability with disability of 40 % or above
--Select--
No
Yes
जन्मतिथि / Date Of Birth*
[Note : DOB as recorded in the Matriculation/10th Standard or equivalent certificate. Where Date of Birth is not available in certificate/mark sheets, issued by concerned Educational Boards, DOB as indicated in School leaving certificate will be considered (in case of Tamil Nadu & Kerala).]
राष्ट्रीयता / Nationality*
Select Nationality
Citizen of India
Other
[Note : All candidates, except Citizen of India, will be required to produce certificate of eligibility issued by the Government of India]
मोबाइल नंबर / Mobile Number*
[Enter Your Mobile Number without 91 or +91 As. 9999988888]
मोबाइल नंबर की पुष्टि करें / Confirm Mobile Number*
ई-मेल / E-mail Address*
[Enter Your E-mail Address which is current and active as any communication from ICHR will be sent on this e-mail only.]
ईमेल की पुष्टि करें / Confirm E-mail Address*
इच्छीत पासवर्ड / Desired Password*
पासवर्ड की पुष्टि करें / Confirm Password*
रैंडम छवि की पुष्टि करें / Random Image*
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