Data Response Sheet

Registration No. : 39
Registration
: 10/8/2019 2:28:18 AM
Date
Examination
: SUPERSPECIALITY (2019)
Name
MUHS PRN No. : 2419123400
Candidate Name : CHAUDHARI NAYAN LAXMAN
DEPT OF CLINICAL PHARMACOLOGY, 1ST FLOOR, NEW OPD BUILDING, KEM
Address :
HOSPITAL, PAREL
Pincode : 400012
PG College
: GMC, AURANGABAD
Name
UG College
: MGIMS, SEVAGRAM
Name
Birth Date : 19/10/1987
Tel. No. : 919665092044
Mobile No : 9665092044
Email ID : nayanlc19@gmail.com
Qualification Details:
Qualification Passing Year Obtained Marks Marks Out of Percentage(%) No Of Attempts
MD/MS AUG-2016 421 800 52.63 1
Final MBBS FEB-2010 826 1310 63.05 1
MBBS II FEB-2008 386 550 70.18 1

Preference Details:
Preference Form No. 21
Preference Date 10/8/2019 2:26:38 AM
Preference No. Preference Details
1 3007-GSMC & KEM HOSPITAL-PAREL,MUMBAI-ASSISTANT PROFESSOR
2
3
4
5
6
7
8
9
10
Declaration

1. I hereby solemly and sincerely affirm that the statement made here and information given by me in the
application form is true and correct.
2. I have concealed any material information, however if any information submitted herein is fraudulent, incorrect
or untrue, I understand that I am liable to criminal prosecution. I understand that the recruitment to thecourse is
also liable to be cancelled.
3. I underake to submitt all the required certificates at the time of my recruitment during recruitment process as per
the rules, failing which my claim for recruitment shall not be granted.
/
Date:- 10/7/2019 12:58:30 PM Signature of the Candidate
There is no need to send this Response Sheet to DMER, Mumbai. But always keep thiswith yourself for future
requirements.