NATIONAL CENTRE FOR DISEASE INFORMATICS AND RESEARCH
INDIAN COUNCIL OF MEDICAL RESEARCH
Department of Health Research,
(Ministry of Health & Family Welfare),
II Floor of Nirmal Bhawan, ICMR Complex,
Poojanahalli Road, Off NH-7,
Adjacent to Trumpet Flyover of BIAL, Kannamangala Post, Bangalore - 562 110. India.
(Application for the post of Consultant (Administration/ Accounts))
Name of the post applied for *  
Name of the Institute / Centre 
Particulars
1. Name in Full: (IN CAPITAL LETTERS) *
2. Date of Birth   (dd/mm/yyyy)
3. Date of Retirement
4. Age as on 31/05/2019
5. Gender
6. Post / Designation held at the time of retirement
7. Name of the organization from where retired
8. Pay Band + Grade Pay or equivalent at the time of retirement
9.  Gross salary at the time of Retirement.
10.  Present Pension drawn
11. Postal Address:*
City*
State
Pincode
12. Contact Telephone No.
13. Mobile *
14. Email address:*  
15. Qualification
16. Experience
17. If selected, what notice period is required before joining?
DECLARATION
I hereby declare that the statement filled in my application is true and correct and nothing has been concealed. I am willing to take up the assignment within immediately after given the offer of appointment.
Date
Place
 
NCDIR, Bengaluru