BSSC Office Copy - Bihar Staff Selection Commission

BIHAR STAFF SELECTION COMMISSION
PO- VETERINARY COLLEGE, PATNA-800014
EXAMINATION NAME: GRADUATE LEVEL COMBINED P.T. EXAM -2010 / ADV. NO - 110
DISCREPANCY REPORT FORM
(BSSC Office Copy)
1. ROLL NO : _____________________(IN WORDS)_________________________________________________
2. NAME :_________________________________________________________________________________
3. FATHER’S NAME :__________________________________________________________________________
4. DATE OF BIRTH :_____-_______-____________.(IN WORDS) ______________________________________
5. DISCREPANCY (IN ADMIT CARD):
S.No. DISCREPANCY REQUIRED CORRECTION
1. Name
2. Father’s Name
3. Date of Birth
4. Gender ( SEX )
5. Category
6. Physical Disability ( DQ )
7. Other ( Image Related or Any)
I hereby declared that all above information is submitted by me is correct. Kindly make the above correction
DISCREPANCY REPORT NO. (OFFICE USE ONLY)____________________
Correction will be made in the Data Base in due course after verification.
Signature of Candidate
(As per Admit Card)
Remarks ( For Office Use Only ) :
Signature of Receiver

BIHAR STAFF SELECTION COMMISSION
PO- VETERINARY COLLEGE, PATNA-800014
EXAMINATION NAME: GRADUATE LEVEL COMBINED P.T. EXAM -2010 / ADV. NO - 110
DISCREPANCY REPORT FORM
(Candidate Copy)
6. ROLL NO : _____________________(IN WORDS)_________________________________________________
7. NAME :_________________________________________________________________________________
8. FATHER’S NAME :__________________________________________________________________________
9. DATE OF BIRTH :_____-_______-____________.(IN WORDS) ______________________________________
10. DISCREPANCY (IN ADMIT CARD):
S.No. DISCREPANCY REQUIRED CORRECTION
1. Name
2. Father’s Name
3. Date of Birth
4. Gender ( SEX )
5. Category
6. Physical Disability ( DQ )
7. Other ( Image Related or Any)
I hereby declared that all above information is submitted by me is correct. Kindly make the above correction
DISCREPANCY REPORT NO. (OFFICE USE ONLY)____________________
Correction will be made in the Data Base in due course after verification.
Signature of Candidate
(As per Admit Card)
Signature of Receiver