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NF-INI ~~~ ----- ~
\itl('~1a 9. o¥/~o ;u~lli it'lt:1~ 1 ~q1~~
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RESERVATION CHART OF VACANT POST NHM 2020-21 RECRUITMENT
SALARY RESERVATIONS SR. POST EDUCATIONAL
NO. NAME QUALIFICATION PER NT NT NT TOTAL
MONTH SC ST VJ (B) (C} (D)
SBC OBC SEBC EWS OPEN
1 MO - Full
MBBS 45000 2 1 3 Time
3 - 1 - 1 5 2 6 24
MO - Full M BBS ,
2 Time Preference M D - - - - - - - 1 - - 1 2
(SNCU) PEDIATRIC/OCH 45000
Preferably MD
3 Pediatrician (PEDIATRIC) - - - - - - - - - - 1 1
/ M BBS OCH 60000 B. Pharm I
4 Pharmacist D.Pharm w ith 1 10000 1 - 1 - 1 - - - - - - 3 Year Experience
5 Staff nurse 12t h pass with
12000 4 - - - - - - 7 - - - 11 GNM Course
TOTAL 8 2 1 1 2 - 1 13 3 2 8 41
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~,.
~ Dy. Director,
Health Services Nashik Circle, Nuhik
~ ....
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Oliitil
nashik1 [email protected] ~ ;., ..
/ . ),
iN :- q16,._di'11 ~ .. :. (Subject) < ',/
Subject :- < Name of post Applied > - < Full Na~ ,f Candidate >
\14=1,(Ui :- 1) Subject :- Staff Nurse - SHRl/SMT. .
2) Subject :- Physician - DR. P. Q . RRR ,
dC(ifd( acifla 'ri ifi14jqq~ \itl~<ldld ~\llifl~i( UPtoAO ~
~\.9) ~:-.qr f~ dliifilcF6t:r'f atvf 14i(IJC4id -ancfT ~ lm' arGf ~ 6(~11C41d ~. ~ !4>i4it;q'llli'*41 ~ ci'tft' ~ ~'Cffif ~ile11l ~ 4'1<~~~ ~ ~ 'ifilft" (Gti~tt 'Gt1'«f
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~r ~I"'// Dy. Director ~.{ Health S · '
N . ervices ash1k Circle Na' L " L
• Sn l i 1
* (~ .T{ir -~·qC'f\C!Uf~C'f\c!l) \1q'9 ... 1Mifi, dfl (Ifft ff "11~. ~, 1111'*•
Deputy Director Health Services Nashik Circle, Nashik
National Health Mission Recruitment 2020-21 Application Form
Paste photo
Applying Corporation Name- ......... ·~ ·· ··· ·· ·········· · · ··· Post Name- ........................ ...... .. .
(All fields in the forms are mandatory to be filled an l:1complete form submitted will be treated as rejected)
Name:
Father's/Husband's Name:
Date of Birth(DD/MM/YYYY) Blood Group: Gender:
Marital status : Existing NHM Empioyee Nationality: (Yes/No)
Original Category : Applying for Category: I Caste Certificate Attached : Yes/No
I Address/Contact Details: (Name of the District and Pin codl! i!> ..,J1npulsory) Address(Present): Address (permanent):(W rite same if same as Present
Address) State State
Pin: Pin:
Contact No: Co11tac. No.
E-Mail Id Correspondence: I
Computer Proficiency: English Typing 40 W.pm (Yes/No): Marathi Typinr; 30 W.pm (Yes/No):
Academic /Professional Educational all summary: (Starting form most recent)
From TO Degree/Diplom University/ lnst itut I Specialization/ Final Year Total Final Year a e Subjects Marks & Percentag
(MM/YY {MM/YY) I Obtained Marks e ( %)
I
I -
I ' I I I
I I Permanent Work Council Registration No: (As Applicable) (MO/SN/Pharmacisr,etc) :-
Work/Experience Summary:( Starti ng form current/most recenc)
Experience in >JHM (Experience of BVG wil l not be counted)
Sr. No I Form To Organization Designation
(MM/VY) (MM/ VY
I I
I I
I I I I
I
l
I
Responsibilities
(Min.30 & Max.SO Words)
Total Experience (In Years & Months): Relevant Experience to the post applied (In Years & Months):
Declaration:
I hereby declare that all statements made in the application are true, Complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue/false/ incorrect or I do satisfy the eligibility crite ria my candidature will be cancelled, without assigning any reason thereof. I have read the content of the advertisement and agree to abide by the rules, regulations and procedures for appointment to t he post appl ied for.
Name:
Place :
Date
________ "" ___________ -----Disclaimer: Checklist for documents (PDF) to be submitted through E-maiJ
l ) Full filled Application fonn in the pres~ 1ibed format.
Signat ure
2) For MO/SN/Pharmacist Valid regis1rauon certificate.(As Applicable) I f not renewed, renewal receipt. 3) For age Proof - School Leaving Certificate/ I 0th or 12 th Passing Certificate 4) Diploma, Degree & Master Degree - Only submit Last Year Certificate and Marksheet 5) If any post-graduation. Post-graduation certificate 6) Experience - Experi ence certificatt. as per mention in the form 7) Computer Profic iency - MS- ClT/ DOEACC Course- fo r the Post of Data entry oprator if applicable.
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NF-INI ~~~ ----- ~
\itl('~1a 9. o¥/~o ;u~lli it'lt:1~ 1 ~q1~~
~ ~ ~ ~ qRtj:s@ia'ta i1 011:::zi1 ~ l:fT fGi~4m16' ~ +f~l'1 4 1'(qli;'S<fil ~ ftCffi 31tiB?'l l ~ ~ sif4iilti1bl @IJlM ('1Cf"C"41 +f~ G!tTfcl il!ISP'llOl ~ er ~ ~ ~ <:1('q lq'( l.SllJl<>'S 4Gitilbl 'YP-f '3iJGql '<i<fi~'1 f-~0;:1{ ~ J:Jl41fclo4 1a ~ ~.
RESERVATION CHART OF VACANT POST NHM 2020-21 RECRUITMENT
SALARY RESERVATIONS SR. POST EDUCATIONAL
NO. NAME QUALIFICATION PER NT NT NT TOTAL
MONTH SC ST VJ (B) (C} (D)
SBC OBC SEBC EWS OPEN
1 MO - Full
MBBS 45000 2 1 3 Time
3 - 1 - 1 5 2 6 24
MO - Full M BBS ,
2 Time Preference M D - - - - - - - 1 - - 1 2
(SNCU) PEDIATRIC/OCH 45000
Preferably MD
3 Pediatrician (PEDIATRIC) - - - - - - - - - - 1 1
/ M BBS OCH 60000 B. Pharm I
4 Pharmacist D.Pharm w ith 1 10000 1 - 1 - 1 - - - - - - 3 Year Experience
5 Staff nurse 12t h pass with
12000 4 - - - - - - 7 - - - 11 GNM Course
TOTAL 8 2 1 1 2 - 1 13 3 2 8 41
~Cf~:-
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~,.
~ Dy. Director,
Health Services Nashik Circle, Nuhik
~ ....
' ' ! f i ~ ; i ~ ' i i ~ f l f ! f t ~ ~ ·~ i i .~ i J; w -r: ~ :i ; l t :i ~ ~ ~ h> w ~ I t .t ? I i : ~ w [ ~ ~:. -.; ·=
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Cfl(1('11J:il tfGfCR ~~ ~ ~ ~ ~.
~¥) ~ $11 H{'"lll \3ilc:"41 <irt1 f.:t~<td'l ~ MG61(Y'4r41~'1 \9 Rcmii:if.4 f.i~<td'l~ R><fi1on ~"! wur ~'1Cfil(Cfl ~ ~ ~ f.i~cffi) ~ ~~ISCIC'i 31T'ff, ~ 41<ftrl'icl ~ \3ftC:Cll(il"i
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Oliitil
nashik1 [email protected] ~ ;., ..
/ . ),
iN :- q16,._di'11 ~ .. :. (Subject) < ',/
Subject :- < Name of post Applied > - < Full Na~ ,f Candidate >
\14=1,(Ui :- 1) Subject :- Staff Nurse - SHRl/SMT. .
2) Subject :- Physician - DR. P. Q . RRR ,
dC(ifd( acifla 'ri ifi14jqq~ \itl~<ldld ~\llifl~i( UPtoAO ~
~\.9) ~:-.qr f~ dliifilcF6t:r'f atvf 14i(IJC4id -ancfT ~ lm' arGf ~ 6(~11C41d ~. ~ !4>i4it;q'llli'*41 ~ ci'tft' ~ ~'Cffif ~ile11l ~ 4'1<~~~ ~ ~ 'ifilft" (Gti~tt 'Gt1'«f
, o a ,..._ ~) ~ as1•-..• ant. ~ •<CNt1ei ~011"'41 q;1'e~ ~ 1" ~ atij\li'itl~ at in- ifll44fi'144iij ;r fltCil(l'i(iij ~ ~ t1'111l q10~\li'itiij ~ at\if ~ o<r..CNt1tt ~ ~ ~ liZffift.
~r ~I"'// Dy. Director ~.{ Health S · '
N . ervices ash1k Circle Na' L " L
• Sn l i 1
* (~ .T{ir -~·qC'f\C!Uf~C'f\c!l) \1q'9 ... 1Mifi, dfl (Ifft ff "11~. ~, 1111'*•
Deputy Director Health Services Nashik Circle, Nashik
National Health Mission Recruitment 2020-21 Application Form
Paste photo
Applying Corporation Name- ......... ·~ ·· ··· ·· ·········· · · ··· Post Name- ........................ ...... .. .
(All fields in the forms are mandatory to be filled an l:1complete form submitted will be treated as rejected)
Name:
Father's/Husband's Name:
Date of Birth(DD/MM/YYYY) Blood Group: Gender:
Marital status : Existing NHM Empioyee Nationality: (Yes/No)
Original Category : Applying for Category: I Caste Certificate Attached : Yes/No
I Address/Contact Details: (Name of the District and Pin codl! i!> ..,J1npulsory) Address(Present): Address (permanent):(W rite same if same as Present
Address) State State
Pin: Pin:
Contact No: Co11tac. No.
E-Mail Id Correspondence: I
Computer Proficiency: English Typing 40 W.pm (Yes/No): Marathi Typinr; 30 W.pm (Yes/No):
Academic /Professional Educational all summary: (Starting form most recent)
From TO Degree/Diplom University/ lnst itut I Specialization/ Final Year Total Final Year a e Subjects Marks & Percentag
(MM/YY {MM/YY) I Obtained Marks e ( %)
I
I -
I ' I I I
I I Permanent Work Council Registration No: (As Applicable) (MO/SN/Pharmacisr,etc) :-
Work/Experience Summary:( Starti ng form current/most recenc)
Experience in >JHM (Experience of BVG wil l not be counted)
Sr. No I Form To Organization Designation
(MM/VY) (MM/ VY
I I
I I
I I I I
I
l
I
Responsibilities
(Min.30 & Max.SO Words)
Total Experience (In Years & Months): Relevant Experience to the post applied (In Years & Months):
Declaration:
I hereby declare that all statements made in the application are true, Complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue/false/ incorrect or I do satisfy the eligibility crite ria my candidature will be cancelled, without assigning any reason thereof. I have read the content of the advertisement and agree to abide by the rules, regulations and procedures for appointment to t he post appl ied for.
Name:
Place :
Date
________ "" ___________ -----Disclaimer: Checklist for documents (PDF) to be submitted through E-maiJ
l ) Full filled Application fonn in the pres~ 1ibed format.
Signat ure
2) For MO/SN/Pharmacist Valid regis1rauon certificate.(As Applicable) I f not renewed, renewal receipt. 3) For age Proof - School Leaving Certificate/ I 0th or 12 th Passing Certificate 4) Diploma, Degree & Master Degree - Only submit Last Year Certificate and Marksheet 5) If any post-graduation. Post-graduation certificate 6) Experience - Experi ence certificatt. as per mention in the form 7) Computer Profic iency - MS- ClT/ DOEACC Course- fo r the Post of Data entry oprator if applicable.
~ ~·~~ ai1~·~ aifil~lil ra:. • ~, i!H~Rf l\qr, ;i1~'1i lir.J, ;i1~'1i '3q~,.lli5ifi ~ E
't (tfl 51~1 NHNI ....... ~ ..... ~~~ -- ~
ill~~l(l -, . o¥J~o ~~I - ilminct
~ ~ affe:liu1ia4Ta ~ 4R4:scoia4Ta ~011;;;q1 Gf'63411"-1 ?:IT f\ii~ii1~161 ~ ai~~~1
4Gi'«41 ~ S1f¢li~161 ©IM'M <"1r:tflll'1 ~~ G!lTftj("l! ISl'"ll O\ ~ er <RR ~ ~ <"1C1:flq< '€11Jl0
qGi~16) ~ \3itG"-11<i<tl"5 '1 ~-itMG:I { 3l'iif '"1 1~ 1rctoiua ~ 3l$r. G'\
SR. POST NAME
NO.
1 Specialist -Psychaiatrist
2 Specialist -
Pediatrician
3 MO Male
UG (RBSK)
MOUG
4 (RBSK MO
Female)
5 Accountant
6 Psychiatric
Nurse
Block
7 Community
Mobilizer
MO - Full
8 Time (NUHM)
RESERVATION CHART OF VACANT POST NHM 2020-21 RECRUITMENT
SALARY EDUCATIONAL
PER QUALIFICATION NT
MONTH SC ST VJ (B)
M D Medicine I 75000 - - - -OPM / DNB
MD Medicine I 75000 3 - - -
OCH/ DNB
BAM S 28000 - 3 - 1
SAMS 28000 1 - - -
B.Com with Tally 17000 - 1 - -Certification
GNM / B.Sc
with
certification in
Psychiatry from 25000 - - - -reputed institut e OR
OPN ORM.Sc Nursing (Psy)
Any graduate
w i th Typing skill, Marathi -
30 words per
m inute , English 17000 - - 1 -40 words per
minute with
MSCITwith 1
Year Experience
M BBS 45,000 - 1 1 -
TOTAL 4 5 2 1
NT
(C)
-
-
2
1
-
-
-
-
3
RESERVATIONS
NT (D)
-
-
1
-
-
-
-
-
1
SBC OBC SEBC EWS OPEN
- - - - 1
- - - - -
1 - 2 2 4
1 - 2 1 7
- - - - -
- - - - 1
- - - -
- 1 1 1 1
2 1 s 4 14
~
~ Dy. Director,
Health Services Nashik Circle, N ;: ~ i ·.n ..
TOTAL
1
3
16
13
1
1
1
6
42
. .
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jalgaon1 [email protected]
Subject :- < Name of post Applied > - < Full Name of Candidate >
\ic:i,(Clf :- 1) Subject :- Staff Nurse - SHRl/SMT. X. Y. m 2) Subject:- Physician -- DR. P. Q. RRR
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Deputy Director Health Services N ashik Circle, N ashik
National Health Mission Recruitment 2020-21 Application Form
Paste photo
Applying District Name- ................................ . Post Name- ................................ .
(All fields in the forms are mandatory to be filled an Incomplete fonn submitted will be treated as rejected)
Name:
Father's/Husband's Name:
Date of Birth(DD/ MM/YYYY) Blood Group: Gender:
Marita l status : Existing NHM Employee Nationality: (Yes/No)
Original Category : Applying for Category: Caste Certificate Attached : Yes/No
Address/Contact Detai ls: (Name of the Distr ict and Pin code is compulsory) Address( Present): Address (permanent):(Write same if same as Present
Address) State St ate
Pin: Pin:
Contact No: Contact No:
E-Mai l Id Correspondence:
Computer Proficiency: English Typing 40 W.pm (Yes/No): Marathi Typing 30 W.pm (Yes/No):
Academic /Professional Educational all summary: (Starting form most recent)
From TO Degree/Dip lorn University/lnstitut Specialization/ Final Year Total Final Year
a e Subjects Marks & Percentag (MM/VY (MM/ VY) Obta ined Marks e ( %)
Permanent Work Counci l Registration No: (As Applicable) (MO/SN/ Pharmacistetc) :-
Work/Experience Summa!') :( Staning fonn current/most recent}
Experience in NHM (Experience of BVG will not be counted)
Sr. No Form To Organization Designation
(MM/YY) (MM/YY
I
Responsibilit ies
(Min.30 & Max.SO Words)
Total Experience (In Years & Months): Relevant Experience to the post applied {In Years & Months):
Declaration:
I hereby declare that all statements made in the application are true, Complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue/fa lse/incorrect or I do satisfy the eligibility criteria my candidature will be cancelled, without assigning any reason thereof. I have read the content of the advertisement and agree to abide by the rules, regulations and procedures for appointment to the post applied for.
Name:
Place:
Date
Disc laimer: Checklist for documents (PDF) to be submitted through E-ma il
I ) Full fil led Application form in the prescribed format.
Signature
2) For MO/SN/Pharmacist Valid registration certificate.(As Appl icable) lfnot renewed, renewal receipt. 3) For age Proof - Schoo l Leaving Certificate/ I 0th or 12 lh Passing Certificate 4) Diploma, Degree & Master Degree - Only submit Last Year Certificate and Marksheet 5) If any post-graduation. Post-graduation certificate 6) Experience - Experience certificate as per mennon in the fonn 7) Computer Proficienc)' - MS- CIT/ DOEACC Course- for the Post of Data entry oprator if applicable.
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€11&flM YGi'Ellt\ ~ '3i?t&Cll <icti~'1 ~-AMiil~ 3fiJf l'll'l fc404 1(1 ~ ~-
RESERVATION CHART OF VACANT POST NHM 2020..21 RECRUITMENT
SR. POST EDUCATIONAL SALARY RESERVATIONS
TOT NO. NAME QUALIFICATION
PER NT NT NT(D) AL MONTH
SC ST VJ (B) (C) SBC OBC SEBC EWS OPEN
Clinical M .phill in Clinical 35000
1 Psycho log Psychology - - - - - - - - - - 1 1 1st
Batchler in
Optometr Optometry from
2 recognised university 20000 - - - - - - - - - - 1 1 1st
with 1 years Experience
Special Educator In Hearing impairment I Visually Impaired I &
3 Special mentally retarded.
25000 - - - - - - - - - - 1 1 Educator (Degree Approved by
rehabilitative Council of India ) with 2 years Experience
Physiothe Graduate Degree in
4 Physiotherapy with 1 20000 - - - - - - - 1 - - - 1 rapist
years Experience
Pharmaci B. Pharm I D.Pharm
5 w ith 1 Year 17000 3 3 2 1 1 - - 1 - - - 11 st
Experience
Medical 6 Officer BAMS 28000 4 4 2 1 2 - - - 3 2 3 21
(Female)
Medical 7 Officer SAMS 28000 3 3 - - - - - 1 3 2 11 23
(Male)
Audiologi Degree in Audiology
st & 8 with 2 Year 25000 - - - - - - - - - - 1 1
speech Experience
Therapist
MOS/ BOS (For BOS -
9 MO 2 Years Experience of
30000 - - - - - 1 1 - - - - -Dental minimum 10 chair
Hospital.)
12th Science with Diploma in Dental
Dental Technician Course.
10 Technicia Registration with 17000 - - - - - - - - - - 1 1
n State Dental Council wit h 2 Years Experience
BE electronics & Tele
Facility comm,
11 JT/coumpeter sci./ 17000 1 - - - - - - - - - - 1 Manager
Dip in electronics w ith 1 year exp.
TOTAL 11 10 4 2 3 - - 3 6 4 20 63
' :
~r ~) ~ Dy. Director, ~' Health Services . .
Nashik Circle , Nashik_,
w i ~ ~ f ! ~ t 'i ; f if i ~; i ~ . ii i t l t j t l
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. ..
anagar1 [email protected]
Subject :- < Name of post Applied > - < Full Name of Candidate >
\141,(Uf :- 1) Subject:- Staff Nurse -- SHRl/SMT. X. Y. ZZZ
2) Subject :- Physician - DR. P. Q. RRR
dC(wfd( a4Rd ri f4i14jqq~ \itifl(ttftd fa\Wit1¥li( UPLOAD ~
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Deputy Director Health Services Nashik Circle, Nashik
National Health Mission Recruitment 2020-21 Application Form
Paste photo
Applying District Name- ................................ . Post Name- ................. ............... .
{All fields in the forms are mandatory to be filled an Incomplete form submitted wi ll be treated as rejected)
Name:
Father's/Husband's Name:
Date of Birth(DD/MM/YYYY) Blood Group: Gender:
Marital status: Existing NHM Employee Nationality: (Yes/No)
Original Category : Applying for Category: Caste Certificate Attached :
Yes/No
Address/Contact Details: (Name of the District and Pin code is compulsory)
Address( Present): Address (permanent):{Write same if same as Present Address)
State State
Pin: Pin :
Contact No: Contact No:
E-Mail Id Correspondence:
Computer Proficiency: English Typing 40 W.pm (Yes/No): Marathi Typing 30 W.pm (Yes/No):
Academic /Professional Educational all summary: (Starting form most recent)
From TO Degree/ Diplom University/lnstitut Specialization/ Final Yea r Tota l Final Yea r
a e Subjects Marks & Percentag {MM/YY (MM/YY) Obtained Marks e ( %)
Permanent Work Council Registration No: {As Applicable) (MO/SN/ Pharmacist,etc) :-
Work/Experience Summary:( Starting form current/most recent)
Experience in NHM (Experience of BVG will not be counted)
Sr. No Form To Organization Designation
(MM/VY) (MM/VY
Responsibilities
(Min.30 & Max.SO Words)
Total Experience (In Years & Months): Relevant Experience to the post applied (In Years & Months):
Declaration:
I hereby declare that all statements made in the application are true, Complete and correct to the best of my knowledge and belief. I understand that in the event of any information being found untrue/false/incorrect or I do satisfy the eligibility criteria my candidature will be cancelled, without assigning any reason thereof. I have read the content of the advertisement and agree to abide by the rules, regulat.ions and procedures for appointment to the post applied for.
Name:
Place:
Date Signature
Disclaimer: Checklist for documents (PDF) to be submitted through E-mail
1) Full filled Application form in the prescribed fonnat. 2) For MO/SN/Phannacist Valid registration certificate.(As Applicable) If not renewed, renewal receipt. 3) For age Proof- School Leaving Certificate/ I 0th or 12th Passing Certificate 4) Diploma, Degree & Master Degree-Only submit Last Year Certificate and Marksheet 5) Jf any post-graduation, Post-graduation certificate 6) Experience - Experience certificate as per mention in the form 7) Computer Proficiency - MS- CIT/ DO EA CC Cour e- for the Post of Data entry oprator if applicable.