Seafarer Profile
Last updated date : 09/10/2019 09:28 PM Date :
: Nautical
Personal Details
Name
Gender
Date of Birth
Place of Birth Birth State
Birth Country Nationality
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PRAVEEN KUMAR GOUR
MALE
05/05/1993
ATARI, RAJASTHAN RAJASTHAN
INDIA INDIAN
16NL2663
179,
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City
State
City
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Pin
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Pin
Address
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Address : :
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Address Details
Present Address Permanent Address
ADHEIYA PATTI,
ATARI,TEHSIL- NADBAI
BHARATPUR
: 321028
RAJASTHAN State :
TEHSIL NADBAI
BHARATPUR
321028
RAJASTHAN
179, ADHEIYA PATTI, ATARI
Country :
Telephone No. :
Country :
Telephone No. :
Mobile No. :
Email Id :
INDIA
*************@*****.***
INDIA
Physical Details
Hair Color
Eye Color :
Height (in Cms) :
: Complexion
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Identification : A CUT MARK ON UPPER LIP
161
BLACK
BLACK
FAIR
INDoS No.
Discipline
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Report generated on : 20/10/2019 10.16 PM Page 1 of 4 Education Details
Name of Institution
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Main Subjects :
Year of Passing :
English Mark :
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Institute Address :
Hindi, English, Science, Social science, Maths and Sanskrit 014****-****
68.17
Amar Jyoti Shiksha Niketan Girls SS
Board of secondary education Rajasthan
Lakhanpur, Bharatpur (Rajasthan)
2 . 10TH (Matriculation/SSC)
Certificate No.
Education Level :
Name of University
PCM Mark Result /Grade
Name of Institution
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Main Subjects :
Year of Passing :
English Mark :
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Institute Address :
Hindi, English, Physics, Chemistry and Mathematics 010****-****
49.55 57
52
Gyan Ganga Sr. Sec. School
Board of secondary education Rajasthan
Deeg Road, Bharatpur (Rajasthan)
1 . 10+2 (HSC/Intermediate/equivalent)
Certificate No.
Education Level :
Name of University
PCM Mark Result /Grade
Total no of record in Education Details : 2
Pre Sea Training Detail
Attended From (Date)
Certificate No.
Pre Sea Tar Book No.
Attended To (Date)
Result
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01/09/2016 31/08/2017
DN/16A/104 1st Sem- 58% & 2nd
Training Institute
Training Institute (other)
International Maritime Academy (Chennai)
Course Name Diploma In Nautical Science
Modular Course Details
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Fire Prevention & Fire Fighting
A-VI/1-2
18/11/2016
DN/16A/104
21/11/2016
International Maritime Academy (Chennai)
21/11/2016
1 . Course Name Fire Prevention & Fire Fighting
Course Name
Report generated on : 20/10/2019 10.16 PM Page 2 of 4 Modular Course Details
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Augmentation of FPFF (Practical Tanker Fire Fighting) 18/11/2016
DN/16A/104
21/11/2016
International Maritime Academy (Chennai)
21/11/2016
2 . Course Name Augmentation of FPFF (Practical Tanker Fire Fighting) Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Security Trng. for Seafarer with Designated Security Duties 15/03/2017
DN/16A/104
16/03/2017
International Maritime Academy (Chennai)
16/03/2017
3 . Course Name Security Trng. for Seafarer with Designated Security Duties Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Personal Survival Techniques
A-VI/1-1
03/04/2017
DN/16A/104
05/04/2017
International Maritime Academy (Chennai)
05/04/2017
4 . Course Name Personal Survival Techniques
Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Personal Safety & Social Responsibilities
A-VI/1-4
10/04/2017
DN/16A/104
12/04/2017
International Maritime Academy (Chennai)
12/04/2017
5 . Course Name Personal Safety & Social Responsibilities Course Name
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STCW Code
Training Institute
Attended From Attended To
Certificate No.
Date of Issue Valid Upto
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Elementary First Aid
A-VI/1-3
18/04/2017
DN/16A/104
20/04/2017
International Maritime Academy (Chennai)
20/04/2017
6 . Course Name Elementary First Aid
Course Name
Report generated on : 20/10/2019 10.16 PM Page 3 of 4 Total no of record in Modular Course 6
Authorised Documents
1 . Document Type : Passport
Document Type : Passport
Document Number :
Valid Upto :
Issued Date :
Issued At :
P8422551 14/03/2017
13/03/2027 JAIPUR
2 . Document Type : CDC
Document Type : CDC
Document Number :
Valid Upto :
Issued Date :
Issued At :
MUM 276980 23/06/2017
22/06/2027 MUMBAI
3 . Document Type : INDoS
Document Type : INDoS
Document Number :
Valid Upto :
Issued Date :
Issued At :
16NL2663 17/11/2017
Total no of record in Authorised Documents : 3
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. DECLARATION TO BE MADE BY CANDIDATE :
Date :
Signature of the candidate
This is an electronically generated document hence it does not require any signature of DGS Officials. Report generated on : 20/10/2019 10.16 PM Page 4 of 4