addl. missiondirector, nhm for anm course... ·...

GOVERNMENT OFWEST BENGALHEALTH & FAMILY WELFARE DEPARTMENT

NATIONAL HEALTH MISSION (NHM)GN-29, 1STFLOOR,GRANTHAGARBHAWAN,SWASTHYABHAWAN PREMISES,SECTOR-V

SALT LAKE, BIOHANNAGAR,KOLKATA - 700 091.

~ 033 - 2353 - 0432, A 033 - 2357 - 7930,Email 10: [email protected]; website: www.wbhealth.gov.in

No. HFW/NUHM-232/2016/649 Dated: .(~.?2017

From : Commissioner, Health & Family Welfare &Add!. Mission Director, NHMGovernment of West Bengal

To CMOH, Asansol HD I Basirhat Health District I Birbhum I Burdwan I Cooch-Behar I DakshinDinajpur I Darjeeling (SMP)I Diamond Harbour HD IHo~IY I Howrah I Jalpaiguri IJhargram HD /Malda I Murshidabad I Nadia I North 24 Parganas /Nandigrarn HDI PaschimMedinipur I Purba Medinipur I Rampurhat HD I South 24 Parganas I Uttar Dinajpur

Sub: Provisional Admission of Trainees for ANM Courseunder NUHM for UPHCin different ULBs

Ref: Notification No. HFW/NUHM-232/2016/3826 dated 9.12.2016

With reference to above, an approved list containing ULBwise selected candidates for ANM trainingunder NUHM received from your end is enclosed. The names of the NursingTraining Institutions (residential orNon-residential) where they will undergo such training have also been indicated ULB wise in the enclosedstatement (Annexure I).

2. You are requested to send the photocopies of all the concerned applications along with all relevantdocuments of selected candidates to the Training Institutions before commencement of the said training. Youare also requested to send intimation to the selected candidates to join the allotted Nursing TrainingInstitutions within the period from 1.6.2017 to 7.6.2017 (excluding holidays). The class of ANM trainingcourse for 24 months duration will be started from 12.6.2017 in all the institutes.

A draft copy of the intimation letter is enclosed.

3. Failure to join the training course in time, or leaving the course midway for any reasons whatsoever,will result in the candidature being cancelled.

4. While sending the letter of admission to training course from the office of the CMOH, it should beclearly indicated that the admission is provisional and is subject to verification of original documents producedby the candidate in support of her age, residence and qualification.

After admission, if any candidate is found ineligible by any competent authority her candidature forundergoing training will liable to be cancelled and she will be terminated from the training course forthwith.Shewill also be liable to refund the stipend money paid to her.

- 2 -

5. The above selection for admission is provisional and subject to the decision or direction in differentcaseswhich may subsequently be received from Hon'ble Courts and competent authority.

6. Admission is also subject to medical fitness of the candidates for which they have to submit MedicalCertificate from a registered Medical Practitioner having at least a MBBSdegree in the prescribed format (copyenclosed). This Medical Certificate is to be kept in the Training Institutions.

7. The selected candidates are entitled to receive an amount of Rs.1000/- (RupeesOne thousand only)per month asstipend, fund for which will be sent to the respective training Institutions.

8. Accommodation will be provided to the trainees where the course is residential. NTSsthose arecompletely residential, the trainees will have to avail themselves of the accommodation.

9. The residential trainees will be provided free accommodation in the hostel. But they will have to makemessing arrangements at their own cost,

List of articles usually required to be brought by each trainee is enclosed.

Enclo -

1. Annexure 12. Specimen copy of Medical Certificate.3. Specimen copy of Model letter of the CMOHto the trainees.4. Specimen copy of Model letter to the Nursing Training Institution.5. List of articles to be brought by the trainees

commiSSV-WJ &Addl. MissionDirector, NHM

No. HFW/NUHM-232/2016/6LtCf/I(It.)Copy forwarded for information and necessary action to:

1. Director of Health Services, West Bengal.2. State Family Welfare Officer, West Bengal, Swasthya Bhawan.3. It. DHS (Nursing), West Bengal.4. Registrar, West Bengal Nursing Council, 8, Lyons Range, Kolkata - 700001.5. Commissioner, (Howrahl Durgapur/ Asansoll Chandannagarl Siliguril Bidhannagar)

Dated:),(.5.2017

6. Executive Officer, (Baduria, Basirhat, Bolpur, Suri, Burdwan, Kalna, Katwa, Coochbehar,Balurghat, Diamond Harbour, Arambag, Baidyabati, Bansberia, Bhadreswar, Champdany,Dankuni, Hooghly Chinsurah, Konnagar, Rishra, Serampore, Uttarpara Kotrang, Uluberia,Jalpaiguri, Jhargram, English Bazar, Old MaIda, Jiaganj- Azimganj, Berhampur, Dhulian, Jangipur,Kandi, Chakdah, Gayeshpur, Haringhata, Kalyani, Krishnanagar, Nabadwip, Ranaghat, Santipur,Ashoknagar Kalyangarh, Bangaon, Baranagar, Barasat, Barrackpore, Bhatpara, Dumdum, Garulia,Habra, Halisahar, Kamarhati, Kanchrapara, Khardah, Madhyamgram, Naihati, New Barrackpore,North Barrackpore, North Dumdum, Panihati, South Dumdum, Titagarh, Ghatal, Kharagpur,

" ..,~

- 3 -

Medinipur, Contai, Haldia, Panskura, Rampurhat, Baruipur, Budge Budge, Maheshtala, RajpurSonarpur, Islampur, Kaliaganj, Raiganj)

7. PNO, District Hospital, Coochbehar8. PNO,District Hospital, North 24 Pgns9. PNO, Chittaranjan Seva Sadan, 37, SP Mukherjee Road, Kolkata - 700 02610. PNO, Howrah District Hospital11. Principal, Dr. H.C. Mukherjee Memorial Health School, Singur, Hooghly.12. Superintendent, Kharagpur SD Hospital, Kharagpur, Paschim Medinipur13. Superintendent, Bolpur SD Hospital, Bolpur, Birbhum14. Superintendent, Vidyasagar S.G. Hospital, South 24 Pgns15. Accounts Officer, ID & BG Hospital, Beliaghata, Kolkata16. Principal / Teacher-in-Charge, NTS attached to District Hospital, Coochbehar / District Hospital, North

24 Pgns /Chittaranjan Seva Sadan/ Howrah District Hospital /Bolpur SD Hospital! Vidyasagar S.G.Hospital, South 24 Pgns / Kharagpur SD Hospital! ID & BG Hospital, Beliaghata, Kolkata

[He/She is requested to admit the trainees after verification of their original documents as well as medicalcertificate in the prescribed format by a Medical Practitioner having at least MBBS degree. He / She isrequested to send us the list of the candidates as soon admission is completed.]

A copy of the selection list as well as specimen copy of M.C. is enclosed for ready reference for 7 to 16only.

commiS~(H&FW) &Addl. Mission Director, NHM

-,

Format for Submission of panel for engagement of ANM under NUHM·

Name of the Dist:Name oft~ie ULBNo of required no of trainee

HooghlyChampdani Municipality

2 UR lSC 1STDetails of(10+2) Examination

Marks

Name a/the Gurdian's date ofobtained ill

SLNo Address witl!Phone Number Cast Board! Yearof Total final %.of RemarksCandidate Name Birth Runk

Institute passing Maries Examination Marks(BestSsubjects)

1 Soumita Das Ujjal Biswas39 RKMLane, Baidyabatl, Hooghly 04-03-1991 Gen WBCHSE 2010 500 246 49.20 1 Selected

712222

2Rima Kaugsa Pranab Kumar 73, Tarakeswar Pally, PO-Angus, 19-09-1989 Gen WBCHSE 2009 500 233 46.6 2 Selected

Banik Barui Bhadeswar. Hooghly.71221..

88, Khurigachi, Natunpara, Waiting ,IS

3 Jharna Ghosh Kartick Ghosh Bhadraswar, Hooghly, Champdant, 10-10-1979 aBC B WBCHSE 1999 1000 458 45.80 3712221

Gell

4 Papiya Das Avijit Dey50.KGRS Path, Tarakeswer Pally, 24-08-1988 Gen Al-ISEC 2007 500 203 40.6 4 WaitingBhadreswar, Hooghly 712124

Signature ofDPHNO wit 1seal &dt ,?\,.'D. P.l3i~~·-'v

. Booghly/

Signature of th~ representative of the District{'Vr.

Mazlsu-ate wit1{Sifals<l:uc;ll)ateo I] ,-' .-,-;'~-""A ic.~r~7~;~

TAPAN OASGUPTl\(Membr 01Legislative f:\sS~~[\;b1';:, \;It f))

Format for Submission of panel for engagement of ANM under NUHM

,~;Imc<.jthe Dist: HooghlyN'I.Jl1C nf the ULB Konnagar Municipality

;80 of required no of trainee 2UR lSC Details of (10+2) Examination

Marks i

Name a/thedate of

obtained in

LNo Gurdians Name Address with. Phone Number Cast Board! Year of Total final %0/ Remarks

CandidateBirth Rank

Institute passing Marks Examination Mades(BestS 1

subjects)

Late Taralmaath64.Vidyasagar

1 SharmisLha Ghosh GhoshStreet.Konnaagar,Hooghly,Pin 25-03-1991 Gen WBCHSE 2009 500 362 72.40 1 Selected

712235

2 Piyali Das Sarkar Sarnir 1(1' Das21/30 GCBose Sarani, PO . 30-09-1988 Gen WBCHSE 2006 1000 693 69.3 2 Selected

Konnazar, Hooghly.712Z35.

3 Puspa Kumari Das Sunil Das23/B/2 A.K.13anerjee Lane, Taltala, 12-06-1988 SC WBCHSE 2007 500 224 44.8 1 Selected

Konnagar.712235.39/ A/6 Lenin Sarani .Po'

'1 Mousurm Burman Sukumar Das Konnagar, Dist- Hooghly. Pin- 07·08-1982 Gen WBCHSE 2001 1000 582 58.2 1 Waiting

712235

Kestopado7/1, Bancharam Mitra Lane, Flat

5 Shatabdi Kar No: 59. Vaishali Housing Complex. 08-10-1981 Gen MSBSHSE 2001 600 281 46.83 2 Waiting

Chowdhary Konnaoor~712235

tgnature of the Hon'ble Chairperson ofthe Recruitment Committee of the

District with seal & Date

Signature of OPHNdate 1

D. P.H.l\l. 0i

Beeghly

mature of the representative of the District~gistrate with Stjflreetain-Ch(;1rw~

Health Section Deputy C.M:O.H...Idate

TAPAN OASGUPT,6.;(Mernbr of Le91siatlve Assemb\}~l

W.B.

Iiil

Format for Submission of panel for engagement of ANM under NUHM8~Hlle.~~..ne Dist:Name ofrhe lJLB

HooghlySerampore Municipality

No of required no oftrainee 3lJH lSC 1ST i onc 1\<" . Details 01(10+2) Examination

Marks

Name of theohtuined ;11

SLNo Gurdian'sName Address with Phone Number dote of Birth Cast Board/ Year of Total filial %of RemarksCml(lil'illtc lIankInstitute passing Maries Exinnlnation Mnrks

(Best 5subjects} 1

Amrita Gourab Chakarborty, 65/1/23 l'D Road.1 Chakraborty Shyama D,iS Chowdhury 24-01-1991 Gen WBCHSE 200B 500 359 71.B 1 Selected

I(Chowdhurv] Vivek Pally , Serampore , Hooghly.712203.

2B/4. Champatala lane, Chantra, Serarnporc, 62.2 2 Selected

Indrani Bhowmik Arup Bhowmik hooghly 712204 18-08-1988 Gell NilE 2006 500 311

3Mousuml Raju Saha

90/ A Khatirbazar Lane, Kalitala, Mahesh, 09-09-1987 Gen WBCIISE 2006 1000 598 59,[1 3 SelectedBanerjee Sail a Serarnnore, Hocahlv 71.2248

'i Payaillas Swara] Das3 No Baishnab Para. 2nd Lane, GT Road, 05-04-1987 SC WnCHSE 2004 1000 584 58.4 J SelectedMahesh, Serampore, Hooghly 712202

59E/8 Borobagan Lane, Mallick Para, 58.2 ) Waiting as UR

Pamela Parra Subhra Parra Serarnpore, Hoogbly 712203 28-1Z-19B9 Cell WBCHSE ZOOS 500 291

6Mousumi Das Bidyut Saha

Moooj Kr Das, 42 Barabagan Lane, Mallick 08-10-1985 SC WBCHSE 2006 1000 537 53.7 2 Waiting as UR(Saba) Para $erampore, Hooghly. 712203.

7 Manashree Hazra Lt Mahindranath Hazra3/1\, Dlnobondhu Chatterjee Lane, PO 12-07-1982 CCll WI3CHS.E 20Q2 1000 S20 52 3 Waiting as lJRMahesh Hooghly 712202

Signature of thl/Mayot, MC/Chairperson,Municipality

Chairmanssrarn ore Municipality

Signature of DPI:lNOwith seal &datc

D. P.H.~. O~'Hooqhly :

Format for Submission of panel for engagement of ANMunder NUHMName of the Dist: HooghlyName of the ULB Rishra MunicipalityNo of required no. of trainee ZlJR 1 SC 1 ST

Details of (10+2) Examination

Marks

Name of the Gurdian r date of obtained inSLNo Address with Phone Number Cast Board f Year of Total final %of ( RemarksCandidate s Name BirOI RankInstitute passing Marks Examination Marks

(BestSsubjects)

SunilSanjoy Dutta, 341, 3No.

1 Supriya Dutta ChandraNutangrarn, Sukantapally, PO - 28-11-1983 Gen MP,

2001 450 329 73.11 1 SelectedMorpukur, Rishra, Hooghly. BhupalDas 712250.Subir 49/ A Nabinpally Morepukur,

Selected2 Sabitri Dutra Dutta Rishra, Hooghly 712250 20-07-1991 Gen WBCHSE 2009 500 323 64.6 2

Prasanta 12/255/A/13 no Water3 Haimanti Mandaal Kumar Tank.Rathin Paal Sarani.Shamoli 24-08-1987 Gen WBCHSE 2005 1000 535 53.50 3 Waiting

Das Marriaage Hall,712250

Amar4 Uma Dutra nath 29/10,3110 Natungram, More 38 4 . Waiting

(Sarkar) SarkaI' pukur, Rishra, hooghly 712250 05-10-1985 Gen WBCHSE 2005 1000 380"-

Signature of the Dy.CMOB- I Signatlv::. f'; ;~tgl1ature of the. Hon'ble Chairperson ofwith Seal and Date . ,thit:¬ 'M'qWOt the Recruitment Committee of the

Deputy C.M.O.H.-t(:;:\'\i~(th seal & District with seal & Dateoozhl date

;ignature of the ~sel1tlltiv.Aflf the)istrict Magistrah;'Uht(f!7!Jl~hrli1Er~

Health Section

Signature of DPHNOwith seal &date I

D.P.B.N.O"BooghlY.I

Signature of the Mayor,MC/Chairperson,

"t.' .A tm~li1.jg~W•. 'O:.J •• " \'. ~ ~ :

J !

Format for Submission of panel for engagement of ANM under NUHMName of the Dist: HooghlyName of the ULB Bansberia MunicipalityNo of required no of trainee 2 UR 1 SC. ,


Marks "1

Name a/the Gurdian' date 0/ obtained illSLNo Address with Phone Number Cast Board / Year of Total final %of Remarks

Candidate sName Birth Rallkinstitute passing Mar/(s Examination Marks

(Best 5subjects)

Sarnpa Sarkar AshokBasudebpur, Pritinagar, Tribani,

J Mogra, Hooghly.712503; 31.05.1986 Gen WBCHSE 2007 SOO 305 61 1 Selected(Dey) Sarkar 8648861532.

2 Kakoli Biswas Dipak Kr Sukantapally, Bansberia, Hooghly 07.05.1988 Gen WBCHSE 2006 1000 453 45.3 2 Selected(Modak) Biswas 712S0~ 9239328417

3Kanika Sarkar NcpalKr Gorbari Ciani, Bansberia, Hooghly 16.03.1985 SC WBCHSE 2003 1000 488 48.8 1 Selected

(Das) Sarkar 712502: 9681553878

Signature of the Mayor, MC/Chairperson.

MunicipalityChairperson

Signature of the Dy. CMOB-lwith Seal and Date

Deputy C.M.~.H.-IHoo hly dat~

"gnature of the Hon'ble Chairperson ofthe Recruitment Committee of the


~3'th

Signature of the representative of theDistrict Magistrate with Seal and Date,

!:lffic8r~in-Ch~rgEtjjIHealth Section. ' D, P.H, ]\1.0

Bansberia Mumclpa ITAPAN DASGUPTA,

(Membrof LegislativeAssemblY i'. \IlL, B.

.',

Name of the Dist:Format for Submission of panel for engagement of ANMunder NUHM

HooghlyName of the ULB Dankuni Municipality

No of required 110 of trainee 2UR 1 SC


Marks "Name of the Gurdian's date of obtained ill

5LNo Address with Phone Number Cast Board! Year a! Total final %0/ RemarksCandidate Name Birth RankInstitute passing Mar1cs Esaminaticn Marks(BestS

subjects)

1 ViIIKharial, Kanaipur, Hooghly70 1 Selected as

Piyali Ghosh Abhra Ghosh 712332;8420792355 01.08,1991 OBC B WBCHSE 2009 500 350 un504,Golden View Appartment, TN

2Shiulyrnala Mukel'jee, South Subhas Pally, Po-

63,4 2 SelectedChakraborty(Ban Pradip Kumar Dankuni, Pin-712311;erjee) Chakraborty 8116723502 04,06.1986 Gen WBCHSE 2003 1000 634

Dankuni, Monoharpur, Malikpara,3 Mrs Barnali Anadi Nonapukur, Hooghly 712311 ; 61.4 3 Waiting

Ghosh Mukherjee 7044555432 15,10.1989 Cell WBCHSE 2008 SOD 307

4 Swapan Dankuni housing Complex,P- 46.3 4 WaitingSaheli l3atabyaal Batabyaal 8/S,WB 712311 02.01,82 Gen WBCHS·E 1999 1000 463

Hooghiy.

Signature of DPHNdate

D. P.H.l\J. 0Booghly

;ignature of the representative of the Districtvlagistrate with Seal and Date

OfficEir"in·Charge, .;·jsalth Section" ' Deputy C.M.O.H.-I with seal &

date

Signature of the Hon'ble Chairperson ofthe Recruitment Committee of the


TAPAN DASGUPTA(Membr of Legislative Assembly)

W.B.

Name of the Dist:Nal~ie of the ULE

HooghlyBhadreswar Muntclpality

UR 1 SC

Format for Submission of panel for engagement of ANMunder NUHM

No. of required no. of trainee 2

Details of (10+2) Examin'ation

Marks Idate of obtained ill

"

itName of the Gurdian' Address with Phone Number

Birth Cast Board/ YeaT'of Total final %0/ RemarksSLNo Candidate sName

Institute passing Marks Examination Marks Rank(Best 5

subjects)

;il:Mousumi Gobinda 201 Tentultala lane, Mankundu,

1('

Chakraborty Nath Bhadreswar, Hooghly 712139;64.4 1 Selected

17595822258/9831222586 27.03.1983 Gen WBCHSE 2001 lOOO 644

Hazra Hazra

Sujoy 177, KGRSPath, Po Bhadreswar,24.10.1989 SC WBCHSE 2007 500 269 53.8 2 Selected as UR

2 Sumita Bast! Basu Hooghly 712124;8961109127

Mantu Kr I Rk Banerjee Street, Telinipara,SC WBCHSE 2004Bhadreswar, Hooghly 712125 05.01.1985 1000 500 50 1 Selected

3 Dipali Monda! Paul ;8584064620

I ~~! . ~ ~@l::6\~~»<: ~\7t

~~:t . ~(X)~' --e/{} '2' U .lot / ~~j ""-~ ']/;/ , .. ~~a\thSignature of DPHNOlwlth seal & Signature oftlfi!rVffdyor Sign'ature of the Dy. ~Ylle1T~a~l!f¬ of

Signature of the Hon 'blc Chairperson ofSignature of the 'eprese~M'e of the

.. ~ ::;'date , MC/Chairperspn,with Seal a~?O:H.-I the CMOIl the Recruitment Committee of the

[)i~trict Magistrate with ,J and DateD. P. H. 1\1.0 ,M)·mj,cipali ty DepUty C. hI with seal & District with seal & Date

. Officer~in-Ch~rgerHooghly Or'

:c.l'JalYtYJ?);'J· <, Hoog Y date•. Health Section, "-~,"\ ... ,.. " P .....LCI._ ~"-'".,j""'.jf" 1'\1 \ ~ll)j~I"tn\!,.LI YNOl.lgrllY·


W.B.I

I I

II, j

.'

Iii

~i')

Format for Submission of panel for engagement ofANM under NUHM

Name of the Dist: HooghlyNUl'>:: of the ULB Chandannagar Municipal Corporation

No of required no of trainee 2 UR lSC

Cast Board/Institute

Details of (10+2) Exanitnation

2009

TotalMarks

Remarks

Cell

Gcn

WBCHSE

WBCHSE

Year ofpassing

2009

500

500

Marksobtained in

final % ofExamination q Marks

(BestSsubiectst

RankGurdian'sName

Address with Phone Numberdate ofBirth

367 73.4 1 Selected

361 72.2 2 Selected

409 40.9 1 Selected

347 69.4 1 Waiting

305 61 2 WaIting

Bazra Roypara, Mankundu,Bhadreswar, Hooghly 712139 ; 13.07.1987 SC WBCHSE 2006 10009804685421Kuthirrnath North,Chandannagore, Hooghly 712136 14.04·.1989 Cen WBCHSE 2009 500;9477395311No.1 Niranjan Nagar,Chandannagar, Hooghly. 712136. ; 08.07.1989 Gen WBCHSE 2007 50094·3286-1·826

s-

Nome of ttieCandidateSL No

RNRoad, Besohata,Sallmyadipta Chandannagore, Hocghly, 712136

Sen ;9830894265SC Sur Road Bye Jane, Sur Para,

05.11.1989

Ir~1/::-~1 ?-.-{ \ 1·

Signature of the representative of the District SignatLlre Of])PH,NO with seal & Si'h~,u;re 0, ft~,MM,~a~:: . ,signature of the ny. CMOH - Idate 0 'Mq,M;~~\lrucipal, with Seal an,dDate,

D. P.H. ~l. C1and~iJ~~Hi\¥n DAft11ty C.M.O.HAHo09nly Corp .....t"-HOOghly

Sigl'm!I (/1 '\)f)"the, 1}'1wi s al&

date

, Signatureof the Hon'bleChairperson of the RecruitmentCommittee of the District with

seal & Date

1 Sushmita Sen

13asudeb Singh .' ..Bagbazar, Chandannagar,Roy I-1ooghly.712136; 9804178520

18.10.19912 Priti Roy

3 Sagorika Roy Biswajit Roy

4 Reshma Kbatun Sk Siraj

5 Nandita PalShambhunath

Pal

Magistrate with Scal;l),ld Qatc ('\"I,"r(I;~t.)\1IC01~In· J< o· 'J~'Health Section!, W,v'\(1hlv,

Formal for Submission of panel for engagement ofANM under NUHMName of the Dist:Name of the ULB

HooghlyArambagh Municipality

1 SCNo.of required no. of traineeDetails of(10+2) EXamination

Marks-rdate 0/ obtained inName of the Gurdian' Address with Phone Number Cast Board/ Year a/ Total finalBirth %0/ Remarks

SLNo Candidate s NameInstitute passing Marks Examination Marks Rank

(Best 5subjects)ViII& PO - Chandur, PS - 13.03.198Baku! Hatnbir Subhin Arambagh, Hooghly.712602. SC WBCHSE 2006 1000 523 52.30 ]

1 Santra Santra 8967884881/8016196076 9Selected~

Signature of the repr:sentative of theDistrict Magistrate with Seal and ~a}e

i:cor~in~Chargell,.',aith Section,

Signature ~ftl~i1 Signature of the Dy.C~~M<l¥lWf{~oiCiP \itj with Seal and Oa.!!; ~\

M~tI1\lR~}Json, ty C.M.O.tt.Municipality OepU" , hly with seal &

date

Signature of the Hon'ble ChairpersolJ ofthe Recruitment Committee of the

District with seal & DateD.P.H.~.OHoo


W.B.

Format for Submission ofpancl for engagement of ANM under NUHM.Name of the Dist:Name of the lILH

BooghlyBaidyabati Municipality

2 UR lSC 1STNo. of required no. of traineeDetails of (10+2) Examination

Marksdate of obtained in

Name of the Gurdian' Address with Phone Number Cast Board! Year of Total finalBirth %of RemarksSLNo Candidate sName Institute passing Marks Examination Marks Rank(BestSsubiectst

Tarak eh161/40 GTRd, Nibeditapally,

Rita Mondal (Rei) l3aidyabati. Hooghly 712222; 20.02.1984 SC WBCHSE 2002 1000 500 SO 1 Selected1 Monda! 9883223668

Signature of the Mayor Signature of the Dy. CMOH - I, MCA~lajq)erson, with Seal and lliItlh I~~m~lWtI . _Deputy C.M.U.n.-

8/;hfJ:II1.,,::,:i J.1.u~,CJP.A1n ¥ H90ghly ,

Signature ofDPHNO with seal &date

\). P.H.1\l· 0; 'ooghly



Signature of the representative of theDistrict MagistJ:~£r.wit~ Seal and Da,~~

,_,;Iicer~m-Charg&.1 ,. 'oJ" I,rleBlth Section I i. .~

with seal &date

TAPAI"J ~ASGUPT/~(Membr of LegIslative ASSi;rnl.,ly')

W.8. VI,

Name of the Dist: HooghlyN3m~ ,~,~the Ut.13 Hooghly Chinsurah Municipality

'No of required no of trainee 3UR1SC1ST

Details of (10+2) ExaminationMarks

Name a/tile date of obtained inSf-No Gurdian 'sName Address with Plume Number Cast, Board/ Year of Total final %0/ RemarksCandidate Birth HalikInstitute passing Marks Examination Marks

(Best 5 1subjects)

1 Susmita Banerjee Monoj Kumar Mondal Akhan Bazar Haridham Lane,13.06.1988 Gell WBCHSE 2006 1000 767 76.7 1 SelectedChlnsurah, Hooghly.

Shyarnbabur2 Sonia Goswami Laate Sudhir Pathaak Chaat.Chinsuraaah.Hocghly 26.05.1990 Gell WBCHSE 2008 500 351 70.2 2 Selected

712108

Susanto Das, Mearbare, Kopidanga,3 Moumita Pal Dipak Pal Chinsurah,Hooghly.712101. 08.12.1990 Gen WBCHSE 2009 500 351 70.2 2 Selected

9836338504

4 Sushama KunduSanjoy Kumar Kundu

Keota 1 No Govt. Colony, Hooghly,26.02.1990 SC WnCHSE 2009 500 327 65.4 1 SelectedSadhukhan Chinsurah, 712104.

Amratala Govt. QTR. S-34 Arnratala5 Pritha Dey Mondal Goutam Dey Mandai lane, Chinshura Hooghly, Pin- 28.11.1986 Gell WBCHSE 2005 1000 617 61.7 1 Waiting

712101;9477123028

Mcarber, North Gorostban,6 Payel Mondal Lt Tapan Mondal Chinsurah, Ilooghly, 712101; 23.04.1991 Gen WBCIlSE 2011 500 306 61.20 2 Wailing

983139692.11704443773 ,,':"

7 Suddeshna Das Suvendu Ghosh 72, Pratappur, Chinsurah, Hooghly2.7.09.1983 Gen WBCHSE 2002 1000 600 60 3 Waiting(Ghosh) 712101;8420691626

ViII Sripatipur, PO Sahagan], PS i'}

Munna Biswas ;8

(Malo)Sitaal Biswas Chinshura, Hooghly 712104 ; 22.02.1983 SC WBCHSE 2001 1000 591 5(H 1 Waiting

8515948712

Signature of the representative of the District,>Magistrate with Seatll·(l,cl.Datg'In Chargl!t '. Ur1iCE.h - - - Vf

Health Section, .'t,

Format for Submission of panel for engagement of ANM under NUHM

Signature of the Dy, CMOB- [withSeal and Date . \

Signature of the Hon'blc Chairperson of theRecruitment Committee of the District with

seal & DateMunicipality

(Memb; ~fLe;i~latl\leAssembly)\N.8.

date

ChaumuliH~~unicipa1ity

,,/

Name of the Dist: HooghIyNan;r2of the Ut..B Uttarpara Kotrang MunicipalityNo. of required no. of trainee 2 UR lSC 1ST

Format for Submission of panel for engagement of ANMunder NUHM'.

Details of (10+2) Examlnation

Marksobtained in ifSLNo Name of the Gurdian's

Address with Phone Number date ofCast Board/ Year 0/ Total final %0/ Remarks

Candidate Name HiI'll,Institute passinq Marks Examination Marks Rank

(BestSsubjects]

1 Kusurn Banerjee Mukul 79 KCMSarani,Po-Bhadrakaali,PS.25.10.87 Gen WBCHSE 2006 1000 722 72.20 1 Selected

Banerjee Uttaarpara.Dt Hooghly.712232

nat No 403, 11/1 Sitalatala Lane,

Selected as2 Iri Saha Koushik Saha Uttarpara. Bhowmick Appt, 25.07.1988 SC WBCHSE 2006 1000 602 60.2 2

URHooghly 712245; 8902376278

521, Kotrung, Udyanpally,.) Babita Kar Roy Uttam Kar Hindmotor, Hooghly 712233; 21.01.1978 SC WBCHSE 1999 1000 437 43.7 1 Selected

,J

9163367109

Rangalal Roy Para, Rice Mill, Makhla,4 Dipa Bera Raghunathpuj-, Hooghly.712247.; 27.06.1988 Gell WBCHSE 2005 1000 585 58.5 1 Waiting

Sera9434669533 "

Biswanath 25/ A Shibtala Street Old, Now 235 Tutu Santra Koley

Santra D.N.K.KGhosh Road. Bhadrakali, 01.01.1983 Gen WBCHSE 20'01 1000' 541 54.1 2 WaitingUttarpara, 712232. ;9062860743


Annexure I

ULBwise Number of ANM & Training Institute

51. required Number selected Residential! Non-No. District ULB of trainee for 1st number of Training Institute residential

phase trainee

1 Hooghly Arambag 1 1 Residential

2 Hooghly Baidyabati 4 1 Residential

3 Hooghly Bansberia 3 3 Residential

4 Hooghly Bhadreswar 3 3 Residential

5 Hooghly Champdany 4 2 Residential

6 Hooghly Chandernagore MC 3 3 Residentia I

7 Hooghly Dankuni 3 2 Residentia I

8 Hooghly Hooghly Chinsurah 5 4 Residential

9 Hooghly Konnagar 3 3 Residential

10 Hooghly Rishra 4 2 Residential

11 Hooghly Serampore 6 4 Residential

12 Hooghly Uttarpara Kotrang 4 3 Residential

Medical Certificate in case of appointment of candidates underWest Bengal state Health & Family Welfare Somiti

Name ot Ihe candidate in tull (in block letters)

Height (without shoe)

Weiglll

Cm.

Kg.

"1 hereby certltv that I hove examined Sri/Smt. " , a

.candidate for employment in tile Wesl Bengal State Health & Family Welfare Samiti. and can'l

discover thaI Sri/Smt , ,.., " ,......... has any disease.

(communicable or otherwise) constitutional weakness or bodily infirmity,

except. " .." " ,,"

I do nol consider this a disqualification for employment in the office of Slate Somiti.

Sri/Srnt 's age is.according to hisown statement. Years,

and by.appearance about. " ""." " yeors".

a. General Development Good/Fair/ Average/Poor

b Vision Righi eye: Leff eye:

i. Uncorrected/Naked eye

ii. Correcled

iii. Nature and degree

c. Teeth: d. Hearing e. Blood pressure:

t. Lung: g. Heart h. Liver

i. Spleen

j. Hernia (present or absent)

k. Hydroeceles (present or absenf)

I. • Urine i. Specific Gravity Ii. Albumin iii. Sugar

rn. Identification marks

n. TheCandidate is

P.~eIoil

Doted:

Signature of Candidate

Attested

. 1

i. Fit

ii. Unfit on account of

iii. Temporarily unfit on account of

Signature of the Medical Pllli:<titioner

Name

Degree

Regn. No.(Seal)

Government of West BengalOffice of the CMOH .

District .No. Date:

ToSmt ..Address .

MunicipalitylMunicipal Corporation .District ..

Sub: Provisional admission for training for ANM Course under NUHM

With reference to above subject, I am to inform you that you are selected for 2 years

ANM training course under NUHM. You are therefore requested to report to the Principal /

Sister Tutor In-Charge or the Officer-in-Charge of the

Nursing Training School positively within

........................ (excluding holidays) .

Failure to join in the training course in time, or leaving the course midway for any

reasons whatsoever, will result in the candidature being cancelled.

At the time of admission you should bring Medical Certificate in the enclosed format

from a registered Medical Practitioner having at least MBBS degree. You should also bring

original certificates in support of the age, educational qualifications, caste certificate and

residential status, which will be returned to you after verification.

Venue of training centre will not be changed under any circumstance.

All trainees are entitled to receive a sum of Rs. 1000/- (Rupees One thousand only) per

month as stipend. Accommodation will be provided to the trainees where the course is

residential. NTS, those are completely residential, the trainees will have to avail themselves of

the accommodation compulsorily. The residential trainees will be provided free accommodation

in the hostel. But they will have to make messing arrangements at their own cost.

List of articles usually required for the residential trainee, which will have to bring by

each trainee is enclosed.

After admission, if you are found ineligible by any competent authority, your candidature

for undergoing training will be liable to be cancelled and you will be terminated from the

training course forthwith. In that case, you will also be liable to refund the stipend money paid

to you.

Selection / admission is provisional subject to decision of any court of law in future in the

matter and verification of original documents as to age, residence, caste certificate and

qualification as well as medical fitness. It is reiterated that selection / admission will be

summarily rejected / cancelled if any of the documents produced by you is found to be notgenuine.

CMOH, District .

Government of West BengalOffice of the CMOH .

District .

No. Date:

ToThe {In-charge of NTS).......................................... {Name of the Nursing Training Institution)

Sub: Admission of trainees for ANMCourse under NUHMfor theUPHC of the ULB

Sir / Madam,

With reference to the above subject I am sending the photocopies of

the applications alongwith all relevant papers of the selected candidates of

Municipality/ Municipal Corporation for taking further

necessary action from your end in terms of letter no .

dated from the Department of Health & Family Welfare, West

Bengal.

Yours faithfully,

CMOH, District

A.N.M. TRAINING UNDER NUHM

LIST OF ARTICLES REQUIRED TO BE BROUGHT BY EACH TRAINEE

FOR RESIDENTIAL STUDENTS

SL No. Materials Quantity1 TRUNK WITH LOCK 1 PC2 MATIRESS SINGLE 1 PC3 PILLOW 1 PC4 MOSQUITO NET 1 PC5 BED SHEET 1 PC6 BED COVER 1 PC

7 BLANKET 1 PC8 MUG 1 PC9 TIFFIN CARRIER/BOX 1 PC10 RICE PLATE 1 PC11 GLASS 1 PC12 BATI 2 PC13 SPOON 2 PC14 BLACK HAIRNET 1 PC15 PERSONAL TOWEL (TOOTHBRUSH,PASTE) 1 PC16 EXTRA LOCK & KEY(FOR ROOM) 1 PC17 B.P. APPARATUS TO BE PURCHASED LATER

ON18 STETHOSCOPE DO19 MONEY (AT LEAST RS.5000/) FOR UNIFORM,BOOKS,

B.P. APPARATUS,STETHOSCOPE etc. - TOKEPT WITH THE STUDENT

20 TORCH 1 PC21 UMBRELLA 1 PC22 PERSONAL DRESSES AS PER NEED23 PENCIL BOX ERASER,PENCIL, PEN,

SCISSOR, RED BLUE PEN24 NOTE BOOKS 8- (No.4-8)25 White paper 4 DISTA

------------------------------------- . --

A.N.M. TRAINING UNDER NUHM

LIST OF ARTICLES REQUIRED TO BE BROUGHT BY EACH TRAINEE

FOR NON-RESIDENTIAL STUDENTS

SL No. Materials Quantity1 BLACK HAIRNET 1 PC2 B.P. APPARATUS TO BE PURCHASED LATER ON3 STETHOSCOPE DO4 MONEY (AT LEAST RS.5000/) FOR UNIFORM,BOOKS,B.P.

APPARATUS, STETHOSCOPE,etc - TO KEPT WITH THE

STUDENT5 TORCH 1 PC6 UMBRELLA 1 PC7 PENCIL BOX ERASER,PENCIL, PEN, SCISSOR,

RED BLUE PEN8 NOTE BOOKS 8- (No.4-8)9 White paper 4DISTA

addl. missiondirector, nhm for anm course... ·...

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