MUZAFFARPUR EMPLOYMENT EXCHANGE REGISTRATION

Employment Exchange

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Personal Details
Exchange	Sub-Regional EE Muzafferpur
First Name*		Father's Name*
Middle Name		Mother's Name*
Last Name		Email Address(If any)
Sex*	Male Female	Date of Birth*	Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec   Year 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Marital Status*	Unmarried Divorcee Married SEPARATED/DESERTED-WOMAN Any Unmarried Widower Widow	Spouse Name
Caste*	General Backward Category 1 Backward Category 2 Backward Class A Backward Class B Backward Class General OBC Schedule Caste A Schedule Caste B Schedule Caste Schedule Tribe	Religion*	-Select- No religion Buddism Christianity Hinduism Jainism Islam Zoroastrian Parsi Sikhism Meiteism Jew Others
Urban/Rural*	Urban Rural Urban	Phone Number
Address for Communication		Province - Permanent Address
Address*		State*	-Select- Andaman and Nicobar Island Andhra Pradesh Arunachal Pradesh Assam Bihar Chandigarh Chhatisgarh Daman and Diu Delhi Dadra and Nagar Haweli Goa Gujarat Himachal Pradesh Haryana Jharkhand Jammu and Kashmir Kerala Karnataka Union Territory of Lakshadweep Meghalaya Maharashtra Manipur Madhya Pradesh Mizoram Nagaland Orissa Punjab Pondicherry Rajasthan Sikkim Tamil Nadu Tripura Uttranchal Uttar Pradesh West Bengal
		State Belongs Information.
City*		State Belongs Certificate Number
State	Bihar	Certifying Authority
District	Muzaffarpur	certificate Date	15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec   2009 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Pincode		Remarks
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