SI. No.

1

\--'E.AI._ )'-'°Y

{at) Government of West Bengal

District Health & Family Welfare Samity Berhampore, Murshidabad, W.B.

Memo No. DH & FWS/NHM/2018/ 2' 0 !? 6 Dated, 2-Cf (3 f 2018 N 0 T I FI C A T I 0 N r-

Sub :- Selection of the contractual staff under NHM & DAPCU of Murshidabad District.

An application in prescribed format are invited from the eligible candidates as per eligibility criterion for the different posts under NHM & DAPCU as mentioned below. Willing candidates shall be required to v1s1t the website www.wbhealth.gov.in, & www.murshidabad.gov.in for details information. Candidate should go through the instructions thoroughly and carefully before submitting application.

Application as per prescribed format supported with relevant documents must reach the office of the Chief Medical Officer of Health, PO-Berhampore, PS-Berhampore, Dist. Murshidabad , Pin-742101 on or before 5.00 pm on 24/04/18 through the Registered Post/ Speed Post only.

Any omission/ suppression of information shall lead to rejection of application or candidature at any stage of the process without any further intimation. The conditions so prescribed shall not be relaxed . Selection will be made as per T.O.R. issued time to time. All appointments will be made on purely contractual for one year.

Name No Of Preferential Mode Of of vacan Age Essential qualification Quali fication Remuneration Selection post cies s -0 "' C/) ~u

::::: <id ..r:: ~ ~ < ::i C/)

~ ~n ~ 0 N

il) .... ~ .... ..... il) ~ t: -0 ;; Candidates il) t: Qualification & Experience: Rs.45000/- ( u~ c: with As decided Total 0

f--< -a ~ experience of Rupees ~ .";:: : 01 by the < 0.. "' Essentially be and MBBS trained by National Forty Five

C/l UR: a Section n Q OJ NACO at one of the NACO designated AIDS Thousand ~ :I: 01 >- Committee 0 Control ~ a'd '° training centres only) 4-< il) E Programme. 0 bJJ :>

il) E -a - · ~ .~ 0 -0 u ~ il.>_

~ ~ .... ·-0 -0

· - il)

5~ C/)

rg f§ lg ~ ~ "d ..... c:

~~ ....... a.> ·o. r.I

.!:::: "' c.. c: 0

e~~ 2 '--' o'd ~

~~~ ..... 0

g~ 0 :a C<l a.> ~ :::.E

"2 :::.E

r:/)

"d u ro o'd

..0 0.... .g <l'.'. ·- r:/) {; CJ:l 3 :3

:::.E ..... ·~

(!) c .!:::: ~ c: a.>-u .~

3 f-< 0.. r:/) "'

0 :il ..... • o'd 8 a.>

!.:::: OJ) tj....; (!)

o= 0 ~u (.) -

-0 ~ a.>·-

:::.E] :::.E

r:/)

u 0.... <l'.'. r:/)

~ ..... a.>

"d c: 4 ;:J .....

..2 v "' c: ;:J 0 u u f-< u .......

Total : 01 UR: 01

Total : 01 UR: 01

Total : 2

SC: 01

ST : 01

00 -0 N ~ ~ -0 c:: 0

~ Vl

~ Q.)

>-0

"° E :l E ·~

~

00 -0 N ~ ~ -0 c:: 0

~ Vl

~ u >-0

"° E :l E ·~ ~

00 -0 N ~ ~ -0 c:: 0

~

~ .., >-0

"° E :l E ·~ ~

Qualification & Experience:

Essentially be and MBBS trained by NACQ at one of the NACQ designated

training centres

Qualification &Experience:

Essentially be and MBBS trained by NACO at one of the NACO designated

training centres

Qualification & Experience:

Post graduate Degree/Diploma in Psychology/Social

Work/Sociology/ Anthropology/Human Development/Nursing; with minimum I years '

experience after PG degree/Diploma, of Working in field of Counselling in Health sector ;Preferably

HIV/AIDS . OR

Graduate Degree/Diploma in Psychology/Social Work/Sociology/Anthropology/Human

Development/Nursing; with minimum 3 years' experience after graduation of Working in the field

of Counselling in Health sector ;Preferably HIV/AIDS.

In case of those recruited from the community of People infected with or affected by HIV/AIDS, The experience will be relaxed to a minimum of one year of experience in the field of HIV I AIDS.

Other expertise required: Working Knowledge of Computer.

Candidates with experience of National AIDS Control Programme.

Candidates with experience of National AIDS Control Programme.

Preference to be given to the candidate with experience of National AIDS Control Programme.

Rs.36000/- ( Rupees

Thirty six Thousand

only)

Rs.37750/- ( Rupees Thirty Seven

Thousand Seven

Hundred Fifty only)

Rs.13000/­( Rupees Thirteen

Thousand only)

As decided by the

Section Committee

As decided by the

Section Committee

Total Marks: 100

i)Written test (85) :50 Marks

MCQ+ 10 Marks Letter Writing+ 10

Marks Paragraph

writing + 15 Marks

Computer. ii) Interview :

15 Marks

Qualification & Experience:

Graduate in Medical Laboratory Technology Total Marks : ..... 00 (B.Sc.) with a minimum I year experience afier 100 -II) 0 -0 N Graduation.

i) Written test c::: ~ OR Preference to ::J ~ (85) :50 Marks - Diploma in Medical Laboratory Technology ( be given to ~ Total: 0

Rs.13000/- MCQ+ IO VJ 8 i:::: DML T ); with minimum 2 years' experience after the candidate Marks Letter "(:) u 0

(Rupees ]~ UR:Ol ~ Diploma with

Writing+ IO 5 SC: "' The services of existing L Ts , who do not hold a experience of Thirteen Marks u VJ a

II) o:i 06 <U DML T may be continued if they have done National Thousand Paragraph >-~~ OBC- 0 Certificate Course in Medical Laboratory AIDS only) writing +15 "° c<:l B: 01 Technology and have more than 5 years' Control Marks .....:i a

u ::l experience of working in the ICTC/PPTCT/ART Programme. Computer. E

£--< -~ centre run under the National AIDS Control ii) Interview : u ....... ~ Programme. 15 Marks

Candidates must have State Medical Laboratory Approved Certificate.

.... Qualification & Ex12erience: II)

Total Marks: -0 c: 00 i) Post Graduate Degree in MSC/ ML T or Degree JOO ~ -0

in Medical lab Technology ( M.L T) or Diploma in i) Written test ~ N ~

ML T ( DML T) from a university I institution Preference to (85):50 Marks c<:l "=? be given to o:i - recognised by the Central Govt. or State Govt. Rs.13000/- MCQ+ 10 0

-0 VJ i:::: (State Medical Faculty Approved. the candidate Marks Letter ou Total: 0

(Rupees .2 0-.. ~ with Writing+ 10 6 o:i <t: I "' ii) Should have completed 10+2 before obtaining experience of Thirteen Marks a ~VJ ST: u diploma or degree. National Thousand Paragraph s::: o:i 01 >-

AIDS -~ ~ 0 only) writing +15 - ~ "° iii) Knowledge of Computer (Having a minimum Control

Marks E _§ ::l Basic Course of 6 Months from Recognised Programme Computer. u E

Institutions) with proficiency in MS office ii) Interview : II) ·g E- Experience : Minimum 2 Years after Degree ( 15 Marks .D ~ c<:l Must have Health Sector) or 3 years after

.....:i Diploma .

Qualification & Experience:

i)Passed 10+2 With Physics ,Chemistry, Mathematics /Biological Science before obtaining

~ diploma or degree

z ii)Diploma in Medical Laboratory Technology ( ..... <1.l DMLT )/ Diploma in Laboratory Techniques(

-0 Total Marks: s:: 00 DLT) from any university /Institution recognised :l - 100

0 by the central or state Government with an Preference to "' N i) Written test ~ ~ experience of I ( One ) year and above in the be given to ro ~ testing of blood and or preparation in Health the candidate Rs.17220/- (70) :20 on GK

i:o -0 + 40 Marks -0 c:: sector. with (Rupees knowledge in 0 Total: 0

..s gj OR experience in Seventeen Blood banks+ 7 i:o 01

"' Bachelor Degree in Medical Laboratory the testing of Thousand ..... ST: a Technology (BML T) from any university blood and or

10 Marks

<2 <) Computer. 01 >- /Institution recognised by the central or state preparation two hundred

..... 0 ii) Academics : 0 '<!" Government with an experience of I ( One) year of Blood and twenty "' E 10 Marks iii): ·;; ;:! and above in Health sector . components( only) Experience I 0 ..... E OR in a licensed <1.l 0... - ~ Post Graduate Degree or Diploma in Medical Blood Bank) Marks :l

r/) ~ iv) Interview : "'@ Laboratory Technology ( M.Sc. in ML T

10 Marks .S:! /PGDML T) from any university /Institution s:: recognised by the central or state Government with ..c u an experience of 6 ( Six) Months in Health sector. <1.l

f-< iii) Working knowledge of computer.

Candidates must have State Medical Laboratory Approved Certificate.

~ Total Marks :

100 00 i)Written test -..... 0 Preference to (80) :20 on GK

<1.l N -0 ~ be given to + 30 Marks s:: ~ :l - Qualification & Experience : the candidate Rs.13200/- knowledge in

= with Blood bank "2 c:: (Rupees ro Total: 0 Post graduate Degree/Masters in experience of Counselling+20 i:o 01

gj Psychology/Social Counselling Thirteen marks Other

8 -0 Vl

0 ST : a Work/Sociology/Anthropology/Hum an in Blood Thousand Medical 0

<)

05 01 >- Development ; with minimum I years' experience Banking two hundred Counselling + 0

4-. '<!" after PG degree/Masters, of Working in the field Counselling only)

10 Marks 0 E of counselling in Health sector (in any Computer. ..... ;:!

..s E licensed a) - ~ Blood Bank). ii) Experience : "' ~ s:: 10 Marks :l 0 iii) Interview : u 10 Marks

Qualification & Experience:

i)Passed I 0+2 With physics ,Chemistry, Mathematics/Biological Science before obtaining

~ diploma or degree

ii)Diploma in Medical Laboratory Technology ( Total Marks : .....

DML T )/ Diploma in Laboratory Techniques( Q) 0()

100 -0 -c: 0 DL T) from any university /Institution recognised Preference to ::s N i) Written test

~ by the central or state Government with an be given to Cll c: Rs.17220/- (70) :20 on GK -a - experience of I ( One ) year and above in the the candidate

+ 40 Marks ro 0 testing of blood and or preparation of Blood with (Rupees o:l c:: knowledge in Total: 0 components in Health sector. experience in -0 ~ Seventeen Blood banks + 0 01 OR the testing of

9 ..s (/) Thousand 10 Marks ST: ti! Degree in Medical Laboratory Technology blood and or o:l 0 two hundred Computer.

..... 01 >< (BML T) from any university /Institution preparation <2 0

of Blood and twenty ii) Academics : """ recognised by the Central or State Government

c: E with an experience of I (One) year and above in components( only) IO Marks

ro ::> iii) Experience ·u E Health sector. in a licensed c: · ~ OR Blood Bank)

: 10 Marks ..c ~ iv) Interview :

<.) Post Graduate Degree or Diploma in Medical Q) 10 Marks E-< Laboratory Technology (M.Sc. in MLT ..D /PGDMLT) from any University /Institution ro .....:) recognised by the central or state Government with

an experience of 6 ( Six) Months in Health sector.

Candidates must have State Medical Laboratory Approved Certificate.

Qualification & Ex12erience:

i)Passed 10+2 With physics ,Chemistry, Mathematics/Biological Science before obtaining

diploma or degree

::8 ii)Diploma in Medical Laboratory Technology (

~ Total Marks : 00 DML T )/ Diploma in Laboratory Techniques(

100 -.... 0 DLT) from any university /Institution recognised Preference to <!) N i)Written test -0 ..,;: by the central or state Government with an be given to c ~ Rs.17220/- (70) :20 on GK :::i experience of I ( One ) year and above in the the candidate - + 40 Marks

;:J 0

testing of blood and or preparation of Blood with (Rupees c: knowledge in VJ Total: 0 components in Health sector. experience in Seventeen u ~ Blood banks+ 10 co 01 Vl OR the testing of

Thousand 10 Marks .... ST: ai Degree in Medical Laboratory Technology blood and or cE C)

two hundred Computer. 01 >- (BML T) from any university /Institution preparation c 0 ii) Academics :

"' ..;- recognised by the Central or State Government of Blood and twenty ·u E with an experience of 1 (One) year and above components( only)

10 Marks

] ::l m iii) Experience E Health sector. in a licensed () -~ OR Blood Bank)

: 10 Marks <!)

iv) Interview : f-< ~ Post Graduate Degree or Diploma in Medical ..0 10 Marks

"' Laboratory Technology (M.Sc. in ML T ~ /PGDML T) from any University /Institution

recognised by the central or state Government with an experience of6 (Six) Months in Health sector.

Candidates must have State Medical Laboratory Approved Certificate.

Total Max. 62 MBBS or equivalent degree from Rs. 40000/- Interview

Post yrs. As on institution, recognized by MCI. ,--.,

::c :38 01/04/18 ~

relaxation Must have complemented compulsory '-'

::c UR- for rotator internship u 0::: 24, SC/ST/O .........

~ SC- BC 4, candidate

0(3 ST- s as per

11

~ 2, Govt.

OBC norms. z -A:

I

.... 4, <!) ()

OBC \+:::< ,.... 0 -B: 4 "@

-~ -0 <!)

~

12 Total MBBS or equivalent Medicine Rs.40000/- Total Marks QJ I... :01 co degree from institution, DTCD/MD :100 .... rl = UR: 0 recognized by MCI. Must Community 1. QJ N I,,) 01 ~ have completeted Medicine Acedemics CQ 0

E-< rl compulsory rotator /Diploma :80 c::: 0 internship /CHA/masters Interview: Q c::

' 0 At Least 50% marks are in public 20 I... VJ QJ n:s required in requisite Health, Basic u !5 VJ

I-Qualifuication Knowledge in 0 n:s

Q) - >-< Computer ~ u 0

:a '° QJ E :::;: :::s I... E 0 ·x ·a n:s QJ ~

V)

13 Total MBBS passed knowledge Preference Rs. :01 VJ in Gynaecology & should be 40,000/- Interview .... Q)

c: ...... C1I UR: co n:s endocrinology given to those u rl "Cl <ll 01 0 ·- who have DGO C1I N "d 0 ......_c::

or at least "O tj< 13 vi < ~u E house staff i... u I-

0 ·-rl co 0

ship in G&O . ..... . s 0 0 c:: i...- =-. C1I u

0 t:; > ~ .s

Vl - 0 ....,_ <t: u ~ 0 C'U . (./) I-- C1I Vl I- Q)

C'U ::c:: s:, 0 0 .~ """ Vl "O NC:: ro

C1I '° 0 ~ :< :c >. n:s n:s

"O ~ ~ ra ....l Q)

I-

14 Total Qualification & Working in Rs.9380/- Total : 100 :01 Experience: Same Field Min Marks ST I- 1 Year 1. :01 J2 vi i)Passed 10+2 With Academics:

c:: E physics ,Chemistry, 85 .2 I-

...... 0 Mathematics/Biological 2.Compuer n:s c::

:><: .._; Science before obtaining Test: 15 :::;: n:s > a:i 0

::i::: ,__ ~ diploma or degree ::i co I-

z rl Q)

' 0 0.

= N Vl ii)Diploma in Medical -......n:s ~ tj< Vl Laboratory Technology ( ·o 0 Q)

·2 ............. DML T )/Diploma in rl c1l .c:: 0 :9 Laboratory Techniques( u c:: "Cl QJ 0 c:: DLT) from any E-< Vl c1l .0 <t: u university /Institution ~ .u ...:l Vl co recognized by the I- 0 >......._

central or state 0 E-tj< (./)

Government ......... :><: u n:s (./) ~

iii) Knowledge in Computer

15 Total Qualification & One Year Rsl 7220/- Total: 100 :01 Experience: Experience in Marks ST RNTCP or 1.Academics :01 i) Passed 10+ 2 With Sputum : 80

physics ,Chemistry, smears 2. Mathematics/Biological microscopy. Experience

00 Science before obtaining in Heallth .-I 0 diploma or degree related Prog N

Q.. ~ .- 10 u ~ ii)Diploma in Medical E--o .-I :z 0 Laboratory Technology ( 2.lnterview : ci:: c::

' 0 DMLT )/Diploma in 15 c: Vl ~ ro Laboratory Techniques( ·a Vl

1-. DLT) from any ·a ro <l) .c ;>- university /Institution u

QJ 0 recognized by the E--o '<t'

.c E central or state ~ :l

...J s Government -~ ro ~ iii) Knowledge in

Computer

16 Total Science Graduate from Same District Rsl 7770/- Total: 100 ....... : 02

00 any recognized Resident will P.M Marks

Q.. .-I 0 u ST N University with Biology Be Preferable 1.

Q ~ cc :01 0 as a paper For Retired Academics: ::> OBC- .-I ii ) The Candidates Govt. 80 :z 0

'"' A: c:: Should have a valid two Employee 2. QJ 0 "t:S 01 Vl Wheeler permanent Rs. 1000/-* Experience c: ro ::> Vl License per Month in Heallth ......... 1-.

'"' ro After 62 Years they have related Prog <l)

0 >-Vl to furnish a fitness .- 10 .E lf'l

'° Certificate indicating QJ E c. :l that they are booth 2.Interview: = 8 V)

·~ Physically & Mentally fit 10 ..... c: ro to Carry out the Job Of QJ ~ E Vl KTS. Expert in driving

1-. ..... ro Motor cycle. ~ <l) QJ >-'"' E--o 0

'"' l.J')

ro s N < :l

ell E ~ ·a ::i:::: ~

.--·~, 1-7~.--~~,--~-l~-,--~~---,-~~~~~~~~~~-,-~~~~~~--,~~~~~--,~~~~~~

Tota Candidates must be Same Rs. 3500/- Total: 50

18

19

20

u ci:: z

: 02 ~ higher Secondary passed Block/Municip P.M Marks ST ~ . Good Communication ality Resident 1. :01 ..J. on Local language of the Academics: SC: S: District. All Candidates 30 (Cl X : 10 01 c:: must be female. +Cl XII: 20)

0 vi Residing Within 5 Km

Total : 01

SC: 01

Total : 05 UR: 02 SC: 02

ST: 01

Total : 01

UR: 01

ell l:'.; from the SDH/BPHC ell Q)

>-0 "'1' 0 ....., Vl i-. ell Q)

>-0 N

c:: 0 Vl ell Vl

~~ Q) 0 >- N 0 . "'1' ~ E......; ::l 0 E

·~ ~

Completed GNM Course From Recognized by Indian/West Bengal

Nursing Council (INC). Nursing Council

Certificate Must Be Provided.

Completed GNM Course From Recognized by Indian/West Bengal

Nursing Council (INC). Nursing Council

Certificate Must Be Provided.

Matriculation pass from recognized board

Experience : Working with Thallassemia Patients and their families

Experience : Working In Nutrition Projects

Experience : Minimum 1

Year & maximum 25

Years

Rs.16860/­P.M+Rs.300 (Washing Allowance per month

)

Rs. 17220/­

P.M

Rs.8000/­P.M.

2.lnterview: 20

Total: 100 Marks

1. Academics: GNM Exam:

60 Class XII :25

2.Interview : 15

Total: 100 Marks

1. Academics

:80

2.Interview : 20

Total: 100 Marks

1. Academics:

60 2.Experience

in Dental College/Clin

ic: 25 3.Interview :

15

21 Total Bachelor's Degree in At Least 2 Rs.12000/- As Desired :01 Social Science or Degree Years P.M By The

c:: / Diploma in Counseling Experience of Selection c:n UR: 0

/Health education/ Working As A Committee u ti)

Q 01 C1l Mass Communication Counselor in a ti) u r- Cl) c. C1l ..-1 Health care z (l.J 0

facility' . >-- N .... 0 . 0 ~~ Con version in - 0 (l.J s,....; MS Office tll ;:::l 0 = s :s 0 ·x u C1l

~

22 Total Inter CA/Inter ICWA/ 3 Years Rs.22700/- As Desired :01 M.COM or MBA (Finance Experience for P.M By The

.... Cl)

/ Material management) Accounting Selection Cl)

~ UR: rl with knowledge of including Committee = 0

::::i 01 N Computer Analysis . ~ Financial .... 0

Cl) ..-1 reporting/ u 0

!E c:: Budgeting/ 0 c:n 0

.~ u ti) Financial C1l t; Q ti) Software and ... u r-b.O c. C1l

sz (l.J Reporting >--E 0 System,

'tj' = E Experience in u (l.J ;:::l Working in u s

health care = ·~ C1l Financing/ = ~ CZ National

health Account 23 Total Graduate in At Least 2 Rs.13,560/- As Desired

u : 03 Psychology /Social Years P.M By The :i: ,...., c. Work/ Anthropology /Hu Experience of Selection ::c: Cll

-=i:: 3 UR: c:: man Development. Working As A Committee 0 '-" s- Vl

Desirable Post Graduate Counselor in a ::c: ~ 02 C1l

u~ SC: Vl

in (MA or MSc.) in Health care r- Cl) ci:: Cll C1l ..-1 r- oil 01 <ll 0 Psychology /Social facility, Con (l.J :i: >-- N ~Q 0 . Work/ Anthropology /Hu version in MS =~ ~ 'tj'

0 man Development. Office. :s "=' s,....; .... ;

;:::l 0 Conversant in MS Office. Preference will 0::.: E -(l.J :i: ·x be given for Vl Q c:: Vl C1l resident in :l<; ~

0.:.: same sub-U E 0

Division. Q

to\\'-\

24 Total 1. graduation (at least l.Training Rs.13560/- •Total 50 :04

o::i 50% marks) course of MPW P.M. Marks ,....,

0 OBC- N I recognized •

~ B:01 ~ 2.lntermidiate (10+2) & sanitary Educational SC:

,...., experience of working as inspector's Qualification ~ 0

::c: 01 c:: MPW /LHV / ANM/HEAL course. : 40 Marks 0 CQ ST: Vl TH WORKER/ Certificate For E-< t1l '-' 02 Vl or higher course in Madhyamik s.. I-0 t1l

Health Education/ : 10 marks ..... Cl) .... >-Vl Counseling OR For Higher > 0 ~ 3. Tuberculosis Health Secondary: .c: s .....

Visitors recognized -;; :::l 10 marks Cl) s For ::c: ·~ course Vl t1l 4. Certificate course in Graduation ·r;; ~ 0 Computer operation ( : 15 marks -:I Min. 2 months. For Post u s..

Graduation : Q.I

.c :I 5 marks

E-< Experience related filed : 10 marks

25 Total: Vl Completed GNM Course Experience: Rs.17,220/- Total: 100 ro - 07 Vl From Recognized by Working In PM. Marks ~ UR:03

~ 00 Indian/West Bengal Health Service 1. Academics (!) -= >- 0

0 OBC- N Nursing Council . Nursing Provider :80 N . z A: 01 '-0 "tj"

Council Certificate Must 0 '-' s.......: ~ SC: 02 :::l 0 Be Provided. 2.Interview : z ST: 01 E c:: 20 0 >:: 0

ro ~

26 Total Qualification & One Year Rs. 6300/- Total: 100 :03 Experience: Experience as Marks

Lab. Tech. l.Academics UR:2. i)Passed 10+2 With : 80 SC:l o::i physics ,Chemistry, 2. ,....,

0 Mathematics/Biological Experience N

0... '<!' Science before obtaining in Heallth u ~ Q ,...., diploma or degree related Prog

CQ 0 > c: .- 10 z 0 ii)Diploma in Medical ~

Vl c:: t1l Laboratory Technology ( 2.Interview: ~ Vl ·o I-DMLT )/Diploma in 15 .... C1l

c:: Cl)

.c: >- Laboratory Techniques( u 0 Q.I ~ DLT) from any

E-< s university /Institution .c :::l ~ s recognized by the ...... ·x central or state t1l ~ Government

iii) Knowledge in Computer

::NOTE::

Total vacancies as stated above is purely contractual anp subject to revision

Conditions of recruitment will be guided by the T.0.R. issued from the Health &

Family Welfare Department, govt. of West Bengal and amended from time to time.

Qualification as stated in the above table must be possessed by the Candidate on

or before the date of publication of the advertisement.

If it is found during verification of testimonials at any stage that the candidate has

acquired qualification as stated above at any date after the date of publication of this

advertisement, his/her Candidature shall be summarily rejected.

RESERVATION: ~ The benefits for reservation of vacancies and age concession for SC, ST, OBC-A, and

OBC- B candidates are admissible to SC, ST, OBC-A, and OBC-B candidates of West

Bengal only.

~ Before final selection, shortlisted candidates belonging to the SC, ST, OBC-A, and

OBC- B category will be directed to furnish original certificate issued by a competent

authority of West Bengal as laid down in the West Bengal Schedule Castes and

Schedule Tribes (Identification) Act, 1994 and SC and Tribal Welfare Department

order no. 261- PW/EC/MR-103/94dated 06/04/1995, for verification of testimonials in support of their claim.

~ SC, ST, OBC-A, and OBC-B candidates of other states will be treated as General

Candidates.

~ Particulars and certificates required: A candidate claiming to be SC/ST/OBC- A/OBC­

B/Physically Handicapped/Meritorious Sportsperson must have a certificate in

support of his/her claim from a Competent Authority as specified below :-

~ For SC/ST/OBC-A/OBC-B candidates [Vide the W.B.S.Cs & S.Ts (Identification)

Act,1994 and S.Cs & T.W. Department order no. 261- TW/EC/MR-103/94 dated

06.04.1995] :-

[i] In the District, the Sub-Divisional Officer of the Sub-Division concerned,

and

[ii] In Kolkata, the District Magistrate, South 24 Parganas or such Additional District

Magistrate, South 24 Parganas, as may be authorized by the District Magistrate,

South 24 Parganas, on his behalf.

CANDIDATES ARE REQUSTED TO MENTION THE NAME OF POST CLEARLY AS PER THIS ADVERTISIMENT IN THE

TOP OF ENVELOP.

~~ -~~~ CMOH & S ;. DH& FW Samit '\-r Murshidabad .

To The Secretary District Health & Family Welfare Samiti & Chief Medical Officer of Health Baharampur, Murshidabad, PIN: 742101

-·- · -· -. Application No.:

Space for pasting recent colour passport size

PHOTOGHRAPH of the candidate with his I her full

Sub:- Application for the post of ................................. ......................... . .. sianature thereon.

1. Name in full (in BLOCK letter)

2. Sex (Put a tick) : Male D Female D 3. Father's Name

4. Date of Birth : DD CD MM CD yyyy

5. Age (as on Date of Advertisement) ................................................................. .

6. Nationality ............................................... .

7. Caste: ........................ (Gen/ OBC·A/ OBC-B/ SC/ST/others):

8. Address for Communication Village I City Post Office Police Station District State

9. Permanent Address Village I City Post Office Police Station District State

10. Contact No. (with STD Code) 11. Essential Qualifications

Qualification Year of Passing

Madhyamik

Higher Secondary

Graduation

Other

: ................................................... PIN Code ............................ . ..

: ................................................ PIN Code ............. ........ .......... .. . : ........... ........ ..... .......... .. ................ Mobile ... ... .... ............... ... ..................... .

University I Total Marks Marks Obtained Percentage of Marks Board Obtained /Institute

12 s >pec1al Qualifications: Qualification Year of University I Board Total Marks Marks Obtained Percentage of

Pass in a /Institute Marks Obtained Diploma in Computer Application

Bachelor in Computer Application

Master in in Computer Application

Diploma I MD Public Health/ Tuberculosis & Chest diseases

13. Experience:·

Govt./ Duration of Working Organization Post Private I

NGO From Date To Date Total Duration

14. List of Self-attested Photocopies- documents enclosed (No other document except mentioned below is required) f Put '..J' mark in boxl : SI Documents Yes No SI Documents Yes No

1. One colour passport size 2.

Voter l.D. Card I Aadhaar card photoi:iraph for verification of Identity

Ration Card I Electricity bill for Mark-sheets & certificate of 3. verification of residential Proof 4. educational qualifications as per

eliaibilitv criterion

5. Mark-sheets & certificate of 6.

Caste Certificate (SC/ ST/ OBC) comouters knowledae Certificate of experiences duly Bank Draft in Original

7. issued by the appropriate 8 authoritv

9. Two wheeler d.-iving license if 10 Physically fit certificate if applicable. aoolicable

DECLARATION: I solemnly declare that (a) all statements made in this application are true, complete and correct; (b) Original documents will be produced on demand; (c) I understand that the concerned authority reserve the right to reject my candidature upon short listing of the candidates based on qualifications and experiences.

Place

Date Signature of the Candidate in full