Online Application for NHM

Title *

Applicant's Name *

Gender *

Date of Birth *

Age on 01/07/2019 *

Father’s Name *

Mother’s Name *

Mobile Number *

Email ID *

Marital Status *

Nationality *

State*

Permanent Address*

Tick if current address is same

Current Address

Institute of Completion of Internship *

Internship Start Date *

Internship Completion Date *

Reservation Category *

MCI Registration Number *

Do you have any Specialization?

YesNo

Other Achievements

Professional Medical Degrees / Diploma Details

Professional Medical Degrees / Diploma *	Institite/College/University Name *	Year of Completion *	Enter only the Overall/Consolidated Percentage for this Professional *
MBBS*
PG
Specialization (If any)

Vacancy Preference 1 *

Vacancy Preference 2

Vacancy Preference 3

MBBS Registration Certificate*

Upload Photograph *
(File should be in JPG/PNG format and less than 100KB)

I hereby declare that the details given in the application form are true, complete and correct according to my knowledge and understanding. I also accept that in the event of any information being found false, incomplete or incorrect at any point of time or if I do not fulfill the qualifications of the eligibility criteria, my candidature may be cancelled without any notice. I have read all the rules, regulations and procedure of the walk-in interview given in the advertisement and I'll strictly adhere to it.
I will continue to observe the departmental website http://upnrhm.gov.in and if I do not contribute to the prescribed post within seven days of publication of the walk-in interview's orders on website, my application will be deemed cancelled.

Note: If called for an interview, the candidate is required to bring copies of the following documents:

Caste certificate (if applicable)
Aadhaar card
PAN Card
Professional mark sheets
Degree certificate
Specialization certificate
Self declaration that you have no criminal enquiries/records.
Medical Certificate from Competant Authority
MCI Registration Certificate
MCI Recognized PG Qualification Certificate

Application invite for Medical Officer as Contractual Vacancies under the National Health Mission, Uttar Pradesh