APPLICATION FOR SELECTION FOR TRAINING PROGRAMME FOR EMPLOYBILITY AND SKILL ENHANCEMENT
(Advt for Trainee Ref no - HR-T&M/2498, DATE: 05-09-2026)
NAME OF THE TRAINING PROGRAMME:
Medical Attendant Training
Hospital Administration Training
Anesthesia/OT Assistant Training
Select a Training Programme
(1) Name in Full:
(2) Father's Name:
(3) Date Of Birth:
(4) Sex:
Male
Female
(5) Age as on:
(6) Nationality:
(7) Religion:
Select a Religion
HINDUISM
ISLAM
CHRISTIANITY
SIKHISM
JAINISM
BUDDHISM
OTHERS
(8) Marital Status:
Single
Married
(9) Caste/Category
SC
ST
OBC
EWS
GEN
(10) Identity Proof(Aadhar No.)
(11) CORRESPONDENCE ADDRESS
House No.
Village/Town
Block/Area
Post Office
District
Select a District
Angul
Boudh
Balangir
Bargarh
Balasore
Bhadrak
Cuttack
Deogarh
Dhenkanal
Ganjam
Gajapati
Jharsuguda
Jajpur
Jagatsinghapur
Khordha
Keonjhar
Kalahandi
Kandhamal
Koraput
Kendrapara
Malkangiri
Mayurbhanj
Nabarangpur
Nuapada
Nayagarh
Puri
Rayagada
Sambalpur
Subarnapur
Sundargarh
State
ODISHA
Pin
Is your Permanent Address same as your Correspondence Address?
Yes
No
(12)PERMANENT ADDRESS
House No.
Village/Town
Block/Area
Post Office
District
State
Pin
(13) Contact Mobile No.:
(14) Email ID:
(15) Educational Qualifications (from Matriculation onwards):
Examination Passed
Subjects
Name of the Board/University
Year of Passing(YYYY)
(16) Experience, if any :-
Name of the Hospital & Address
From(DD/MM/YYYY)
To(DD/MM/YYYY)
Total Period(in days)
(17) Whether presently employed with any Public Sector Undertaking/Autonomous Body/Govt. Deptt. ?
Yes
No
A set of Self Attested photocopies of the documents in support of the above declaration shall be produced at the time of Interview