Report generated on : **/**/**** *.** PM Page * of 2
Personal Details
Name : SHARMA GIRISH MUKUND
INDoS No. : 18GL4249
Discipline : Nautical
Gender : MALE
Date of Birth : 07/04/1994
Place of Birth : NAVSARI Birth State : GUJARAT
Birth Country : INDIA Nationality : INDIAN
Address Details
Present Address Permanent Address
Address :
FLAT NO-103 BLDG NO-B/23 SHANTI
Address :
FLAT NO-103 BLDG NO-B/23 SHANTI
ACCORD ACCORD
:
SHANTI PARK NEAR GOKUL VILLAGE
:
SHANTI PARK NEAR GOKUL VILLAGE
MIRA MIRA
: ROAD EAST MIRA-BHAYANDER THANE : ROAD EAST MIRA-BHAYANDER THANE City : THANE City : SHANTIPARK MIRA ROAD EAST
Pin : 401107 Pin : 401107
State : MAHARASHTRA State : Maharashtra
Country : INDIA Country : INDIA
Telephone No. : Telephone No. : 843-***-****
Mobile No. : 843-***-****
Email Id : **********@*****.***
Physical Details
Height (in Cms)
Eye Color
Identification
: 164
: BROWN
: MOLE ON LEFT CHEEK
Hair Color
Complexion
: BLACK
: FAIR
Pre Sea Training Detail
Training Institute : BP Marine Academy - Panvel (NAVI MUMBAI) Training Institute (other) :
Course Name : Training for General Purpose Ratings Attended From (Date) : 01/07/2018 Attended To (Date) : 31/12/2018 Certificate No. : G1812B02058/DEC18/64649 Result : B Pre Sea Tar Book No. :
Seafarer Profile
Last updated date : 18/04/2019 06:59 PM Date : 18-Apr-2019 Report generated on : 18/04/2019 7.03 PM Page 2 of 2 Rating Certificate
1 . Rating Certificate : G1812B02058
Certificate No
: G1812B02058
Date of Issue
: 11/02/2019
Issued At : B.P. MARINE ACADEMY(201002)
Remarks : B
Authorised Documents
1 . Document Type :Passport
Document Type
Document Number
Valid Upto
: Passport
: S8286247
: 23/09/2028
Issued Date
Issued At
: 24/09/2018
: MUMBAI
2 . Document Type :CDC
Document Type
Document Number
Valid Upto
: CDC
: MUM 363918
: 03/02/2029
Issued Date
Issued At
: 04/02/2019
: MUMBAI
Training Details
Sr. No. Institute Name Course Name
Joining
Date
Start
Date
End
Date
Certificate No
Certificate
Issue Date
1. BP Marine Academy Basic Safety Training
13-
AUG-
2018
13-
AUG-
2018
25-
AUG-
2018
BPMA/B-
STCW/1296/2018
25-AUG-
2018
2. BP Marine Academy
Basic Training for Oil and
Chemical Tanker Cargo
Operations
08-
APR-
2019
08-
APR-
2019
13-
APR-
2019
2010010761905417
13-APR-
2019
3. BP Marine Academy
Security Trng. for Seafarer
with Designated Security
Duties
10-
AUG-
2018
10-
AUG-
2018
11-
AUG-
2018
BPMA/STS/3475/2018
11-AUG-
2018
4. BP Marine Academy
Training for General Purpose
Ratings
01-
JUL-
2018
01-
JUL-
2018
31-
DEC-
2018
G1812B02058
11-FEB-
2019
This is an electronically generated document hence it does not require any signature of DGS Officials. DECLARATION TO BE MADE BY CANDIDATE :
I hereby declare that the particulars entered in the form are correct and true to the best of my knowledge and belief and that the papers enumerated in this form are true and genuine documents given and signed by the person whose names appears on them. I further declare that Seagoing service information entered is a true and correct account of my sea-going service without exception and I make this declaration conscientiously believing the same to be true. The documents in original will be presented to the examiner at the time of taking oral examination or at an earlier time when asked by the department. Signature of the candidate
Date :