TRANSLATIONAL HEALTH SCIENCE AND TECHNOLOGY INSTITUTE
(An Autonomous Institute of the Department of Biotechnology, Govt. of India)
496, Udyog Vihar Phase III, Gurgaon- 122 016
 
Online Registration Form
 
 
 
POST APPLIED FOR  
     
FULL NAME  
FATHER’S NAME  
MOTHER’S NAME  
DATE OF BIRTH  
 
AGE 54 YEARS, 10 MONTHS, 22 DAYS
GENDER  
Male Female
CATEGORY  
SC ST OBC PH GEN EX-S
NATIONALITY  
     
ADDRESS CORRESPONDENCE  
     
ADDRESS PERMANENT  
     
EMAIL ID  
TELEPHONE NO
     
MOBILE NO  
 
 
ACADEMIC/ PROFESSIONAL QUALIFICATIONS
 
Name of Examination Year of Passing Subjects Board/ University %(Round Off) CGPA Division
Class X
Class XII
Graduation
Post Graduation
Ph.D.
Others
 
Total Experience:
 
Declaration:
 
I declare that I fulfil the eligibility conditions as per the advertisement and that all the statements made in this application are true, complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found false or incorrect at any stage or not satisfying the eligibility conditions according to the requirements mentioned in the advertisement, my candidature/ appointment is liable to be cancelled/ terminated.
 
 

Place:

  
   
Date: Signature of the candidate