28
Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services (Medical Administration) Branch Salt Lake, Kolkata-700091 No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 Dated, Kolkata the 22nd October, 2020 NOTIFICATION The Governor is pleased to appoint the Doctors, enlisted in the AnnexureA, temporarily on recommendation of West Bengal Health Recruitment Board as General Duty Medical Officer (GDMO) in the cadre of West Bengal Health Service (WBHS) and to post them in the places as noted against each. 2. Their services are liable to be terminated in case of adverse observation in their antecedent on further verification by appropriate authority. 3. The appointees will be liable for getting transferred to any station within the State of West Bengal in the interest of public service. 4. The candidates will draw a pay in the Pay Band (PB-4A) of 15,600-42,000/- plus Grade Pay of 5,400/- as per WBS (ROPA) Rules, 2009 read with F.D. Memo No. 961-F(P), dated 07.02.2011. Besides the grade pay, the candidates will draw other allowances as admissible to the officers of WBHS. 5. The candidates shall be governed by the terms and conditions, applicable to the officers of WBHS. They shall be required to perform all such duties as may be assigned to them from time to time by appropriate authority other than the duties of the posts in which they have been appointed. 6. The candidates are hereby directed to report themselves for duties to the concerned C.M.O.H./ M.S.V.P. immediately within 7 (Seven) days from the date of issue of this order positively. No T.A. for joining the post will be allowed to them. 7. No request for extension of joining time will be entertained and no correspondence in that regard shall be made to the applicant. 8. The candidates, who are already engaged earlier as Contractual Specialist/ Senior Resident, under indemnity bond and presently have been selected as GDMO in this current recruitment process, may be allowed to join in service, after obtaining formal release from the Directorate of this Department, with a condition that their professional and educational documents retained by the department, will be only released after completion of their respective bond period. 9. If in due course, any candidate is found already in service and have not followed proper procedures, the present appointment will be treated as cancelled. 10. The C.M.O.H./ M.S.V.P.s are requested to take immediate steps for Medical Examination of the candidates by Medical Board in terms of Health Directorate’s Circular No. Estt./1M-258/76/79 dated 26.06.1977 on reporting and allow them to join, if found fit. A copy of the Medical Examination report should be forwarded to the Assistant Director of Health Services (P&E), West Bengal. They are also requested to verify all the testimonials relating to educational qualifications, Certificate of Registration, etc. of the candidates before allowing them to join. 11. The candidates will have to submit two copies of filled up PVR to the office of the C.M.O.H./ M.S.V.P. at the time of joining the service, failing which they will not be allowed to join. The C.M.O.H./ M.S.V.P. will send these PVR to the Superintendent of Police of the concerned district for verification. Blank copy of PVR format may be downloaded from the Annexure-B of this order, published in the official website (www.wbhealth.gov.in). 12. If any adverse report is found during verification of PVR, the service of the candidate is liable to be terminated, without any further notice. 13. The C.M.O.H./ M.S.V.P.s are requested to send the joining status by email to the email IDs [email protected], [email protected] and [email protected] within 7 (seven) days of their joining.

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Page 1: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 1

Government of West Bengal Department of Health and Family Welfare

Swasthya Bhavan, GN-29, Sector-V, Health Services (Medical Administration) Branch

Salt Lake, Kolkata-700091

No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20

Dated, Kolkata the 22nd October, 2020

NOTIFICATION

The Governor is pleased to appoint the Doctors, enlisted in the Annexure–A, temporarily on

recommendation of West Bengal Health Recruitment Board as General Duty Medical Officer (GDMO) in the

cadre of West Bengal Health Service (WBHS) and to post them in the places as noted against each.

2. Their services are liable to be terminated in case of adverse observation in their antecedent on further

verification by appropriate authority.

3. The appointees will be liable for getting transferred to any station within the State of West Bengal in the interest

of public service.

4. The candidates will draw a pay in the Pay Band (PB-4A) of ₹15,600-42,000/- plus Grade Pay of ₹5,400/- as per

WBS (ROPA) Rules, 2009 read with F.D. Memo No. 961-F(P), dated 07.02.2011. Besides the grade pay, the

candidates will draw other allowances as admissible to the officers of WBHS.

5. The candidates shall be governed by the terms and conditions, applicable to the officers of WBHS. They shall

be required to perform all such duties as may be assigned to them from time to time by appropriate authority

other than the duties of the posts in which they have been appointed.

6. The candidates are hereby directed to report themselves for duties to the concerned C.M.O.H./ M.S.V.P.

immediately within 7 (Seven) days from the date of issue of this order positively. No T.A. for joining the post

will be allowed to them.

7. No request for extension of joining time will be entertained and no correspondence in that regard shall be made

to the applicant.

8. The candidates, who are already engaged earlier as Contractual Specialist/ Senior Resident, under indemnity

bond and presently have been selected as GDMO in this current recruitment process, may be allowed to join in

service, after obtaining formal release from the Directorate of this Department, with a condition that their

professional and educational documents retained by the department, will be only released after completion of

their respective bond period.

9. If in due course, any candidate is found already in service and have not followed proper procedures, the present

appointment will be treated as cancelled.

10. The C.M.O.H./ M.S.V.P.s are requested to take immediate steps for Medical Examination of the candidates by

Medical Board in terms of Health Directorate’s Circular No. Estt./1M-258/76/79 dated 26.06.1977 on reporting

and allow them to join, if found fit. A copy of the Medical Examination report should be forwarded to the

Assistant Director of Health Services (P&E), West Bengal. They are also requested to verify all the testimonials

relating to educational qualifications, Certificate of Registration, etc. of the candidates before allowing them

to join.

11. The candidates will have to submit two copies of filled up PVR to the office of the C.M.O.H./ M.S.V.P. at

the time of joining the service, failing which they will not be allowed to join. The C.M.O.H./ M.S.V.P. will

send these PVR to the Superintendent of Police of the concerned district for verification. Blank copy of PVR

format may be downloaded from the Annexure-B of this order, published in the official website

(www.wbhealth.gov.in).

12. If any adverse report is found during verification of PVR, the service of the candidate is liable to be terminated,

without any further notice.

13. The C.M.O.H./ M.S.V.P.s are requested to send the joining status by email to the email IDs

[email protected], [email protected] and [email protected] within 7 (seven) days of their

joining.

Page 2: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 2

14. Annexed are the list of General Duty Medical Officer (GDMO) and Blank Format of PVR (in Annexure B).

15. All concerned are being informed.

By Order of the Governor

Sd./=

Deputy Secretary

to the Government of West Bengal

No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20/1(29)

Dated, Kolkata the 22nd October, 2020

Copy forwarded for information & necessary action to the---

1. Principal Accountant General (A & E), West Bengal.

2. The Accountant General (A & E), West Bengal

3. The Accountant General (Local Bodies Audit), West Bengal, CGO Complex, Salt Lake City, Kolkata- 700064

4. The Director of Health Services, Government of West Bengal

5. The Director of Medical Education Services, Government of West Bengal

6-8. Additional Director of Health Services (Admn/AA&V/ Accounts), West Bengal.

9. Principal/ Director, ______________________________________________________________________ With a

request not to release all original documents/ mark sheets of the Indemnity Bond candidates, which has been retained by

his Institution till successful completion of BOND period and compliance report from department, obtained at the end of

BOND PERIOD.

10. MSVP, ____________________________________________________________________

11-12. Deputy Director of Health Services (Admn/ HA), West Bengal.

-Institution-wise placement of the candidates placed in Annexure C for Administrative purpose.

13. Assistant Director of Health Services (P&E), West Bengal.

14. Pay & Accounts Officer, Kolkata Pay & Accounts Office, 234/4, A J C Bose Road, Lala Lajpat Rai Sarani, Kolkata, West

Bengal – 700 020.

15. Pay & Accounts Officer, Kolkata Pay & Accounts Office–III, Subhanna, SGO Complex, 5th and 6th Floor, Plot no. 9, DF

Block, Sector–I, Salt Lake City, Kolkata – 700 064.

16. Chief Medical Officer of Health, ______________________________________________

17. Superintendent/ BMOH,_____________________________________________________

18. Treasury Officer, ___________________________________________________________

19. P.A. to the Secretary (Health), Department of Health & FW

20. P.A. to Director SPSRC & Secretary (MS), Department of Health & FW

21. P. A. to MD (NHM), Commissioner (Family Welfare) & Secretary, Department of Health and Family Welfare.

22. P.A. to AMD (NHM), Project Director, WBSAPCS, Member Secretary SBDC, Addl. Secretary, Dept. of Health & FW

23. P.A. to the Addl. Secretary (MES), Dept. of Health & FW

24. P.A. to the Joint Secretary (HS) of this Department.

25. Dr. ______________________________________________________________________

26. _________________________________________________________________________

27. Co-ordinator I.T. Cell; to publish the order in the website along with the Annexure

28. Dealing Assistant

29. Guard file.

Deputy Secretary

to the Government of West Bengal.

Page 3: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 3

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

1

9002

51

5499

0

Suman Roy Atanu Roy

2/6 Chasa Dhopa Para

Lane,

P. O. Botanical Garden.

Howrah 711103, West

Bengal-711103 15

-Mar

-93

M UR No Parbatpur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

2

9008

91

5513

6

Mishmi Pal Santosh Pal

LALA SCHOOL ROAD,

NONA

CHANDANPUKUR,

EAST

RABINDRAPALLY,

JAFFARPUR (CT),

NORTH 24 PGS-700122

01

-May

-94

F UR No Bahadurpur

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

3

9008

77

5513

5 Md Alif

Islam

Md Jaidul

Islam

Vill + P.O- Hasimnagar

(Mollarthesh), P.S- Falta,

Dist- 24pgs (South)-

743513

16

-Sep

-94

M UR No Ballavpur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

4

9013

72

5524

1 Ashok

Sharma

Ram Badan

Sharma

VILL-BAGWARA, P.O-

LARUARA, P.S-

MUFFASIL,

BEGUSARAI, BIHAR-

851218 08

-Sep

-84

M UR No Shibpur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

5

9000

66

5493

2 Swatantra

Burman

Shyamal

Kumar

Barman

B 31 metropolitan co

operative housing

society,Pragati

Maidan,Kolkata-700105

28

-Feb

-89

M UR No Kelejhora

BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

6

9009

17

5514

1 Brijesh

Kasaudhan

Gajanan

Prasad

Kasaudhan

48A/H/12, K.M.SARANI,

C.G.R ROAD,

KOLKATA-700023

19

-Dec

-90

M UR No Laudoha RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

7

9020

91

5539

5

Suvajit Nath Subhasis Nath

PO&VILL:JHOREHAT,V

IA:ANDUL MOURI,

OPPOSITE JHOREHAT

POST OFFICE, NEAR

PRABHU

JAGATBANDHU

COLLEGE,

DIST:HOWRAH-711302

24

-Ap

r-93

M UR No Laudoha RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

8

9021

62

5540

6 Saptarshi

Kansabanik

Subrata

Kansabanik

Narkel Bagan, Chinsurah,

Hooghly-712101

05

-No

v-9

4

M UR No Ichhapur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

9

9008

64

5513

0 Abhay

Kumar

Arun Kumar

Yadav

VILL- LITIYAHI, P.O-

DINAPATTI, P.S-PIPRA,

DIST-SUPAUL-852218

09

-Mar

-89

M UR No Churulia PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

Page 4: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 4

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

10

9021

57

5540

4 Bisweswar

Patra

Mahendra

Kumar Patra

Vill-Tatar Khan ; Post-

Sekhendari ; P.S.- Daspur ;

Dist-Paschim Medinipur ;

West Bengal-721146 14

-Ju

l-8

9

M UR No Khandra

Ukhra RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

11

9016

22

5529

5 Aveek

Sankar

Kumar

Amlan Sankar

Kumar

EAST BLAZE NURSING

HOME PO

MOKDUMPUR, PS

E.BAZAR, MALDA

732103-732103 23

-Dec

-91

M UR No Bhutni Diara

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Malda

12

9014

79

5526

6

Saubhik Pal Biswanath Pal

26/4,RAJA BROJENDRA

NARAYAN ROY

STREET,P.O.-KALAKAR

STREET,P.S.-

POSTA,DISTRICT-

KOLKATA(W.B)-700007 1

1-J

un

-92

M UR No Dhenua PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

13

9009

71

5515

7 Atul

Jaishwal

Kamlesh

Jaishwal

3 Dr G S Bose Road-

700039

08

-No

v-9

2

M UR No Marichkota

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

14

9019

01

5535

7

Subha Maity Badal Maity

VILL-DEBKUL, POST-

HAT SARBERIA, P.S-

DASPUR, DIST-

PASCHIM MEDINIPUR.

PIN-721146-721146 06

-Sep

-94

M UR No Kumardiha

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

15

9013

43

5523

4 Nabarun

Chakraborty

Dibakar

Chakraborty

VILL MOHANPUR

PASCHIM MEDINIPUR-

721436

26

-Mar

-95

M UR No Barwan RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Murshid

abad

16

9012

32

5520

8

Om Shankar Ram Nath

Singh

1042 naskar hat,

rabindra pally ,

tiljala

south 24 parganas

west bengal-700039 20

-Jun

-84

M UR No Kanapukur

BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Murshid

abad

17

9019

04

5482

6

Asif Khan Akhatar Khan

VILL-ISLAMPUR, P.O-

ISLAMPUR, P.S-

ISLAMPUR, DIST-

JHUNJHUNU, STATE-

RAJASTHAN-333024 10

-Jun

-90

M UR No Khandra

Ukhra RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

18

9000

33

5492

7 Aparna

Tewari

Pramod

Kumar Tewari

18 Kashi Dutta street-

700006

03

-Feb

-95

F UR No Krishnapur

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Murshid

abad

19

9018

77

5535

1 Garbita

Sarkar

Gautam

Sarkar

F-5/1, Karunamoyee

Housing Estate, Sector - 2,

Salt Lake City, Kolkata-

700091

29

-No

v-9

5

F UR No Sadikhan's

Dearh RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Murshid

abad

Page 5: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 5

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

20

9002

47

5498

9 Nilabjo

Ghosh

Nirupam

Ghosh

7, CHRISTIAN

PATHWAY

THAKURPUKUR,

KOLKATA-700063-

700063 28

-Mar

-94

M UR No Lalkuti PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Murshid

abad

21

9025

93

5550

8

Satarupa Sen Sudip Kumar

Sen

BUNGALOW NUMBER

409, 4TH AVENUE,

NEAR CME GATE,

KHARAGPUR-721301

07

-Au

g-9

5

F UR No Rajnagar

BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

22

9009

23

5514

5 Rajdeep

Bhattacharya

Pradip Kumar

Bhattacharya

112/6/A/1 DANGAPARA

ROAD P.O.-RAHARA

DISTRICT-NORTH 24

PARGANAS-700118 27

-Jun

-89

M UR No Chakda PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

23

9001

07

5494

2 Sagnik

Bhattacharya

Binoy

Bhattacharya

8/1 Vidya Mandir road

Purba putiary south 24

parganas-700093

16

-Oct

-93

M UR No Bara PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

24

9010

77

5517

8 Soumyadipta

Sanyal

Late Sadhan

Kumar Sanyal

2,DR.A.K.PAUL ROAD,

BEHALA S.O.

BEHALA , KOLKATA

WEST BENGAL - 700

034-700034 10

-Ap

r-94

M UR No Amarpur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

25

9019

81

5537

2 Sibnath

Ghosh

Debasish

Ghosh

MALANCHA,

CHANDIPUR, P.O-

RAKHAJUNGLE,KHAR

AGPUR,DIST-PASCHIM

MEDINIPUR,WEST

BENGAL-721301

08

-Au

g-9

6

M UR No Trilochanpur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

26

9013

15

5522

4 Mohammad

Nasim

Akhtar

Mohammad

Nayeemullah

VILL-SHIBNAGAR

EAST PART (M CORP),

P.O-PRADHAN NAGAR,

P.S-PRADHAN NAGAR,

DIST-DARJEELING-

734003

30

-Jan

-92

M UR No Purandarpur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

27

9019

91

5537

3 Ayan

Majumdar

Arun

Majumdar

79 Prabartak pally ( 2),

Kamarhati, Belgharia-

700056

12

-No

v-9

2

M UR No Panchra PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

28

9011

12

5518

6 Pritam

Kumar Dam

Shyamal

Kanti Dam

EAST

BELBARI,BELBARI,GA

NGARAMPUR,DAKSHI

N DINAJPUR-733124

10

-Mar

-93

M UR No Jatra PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

Page 6: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 6

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

29

9003

46

5501

0 Syed Sakirul

Islam

Syed

Mozammal

Haque

Vill-Layekpara, P.O-

Banharishpur, P.S-Panchla

Dist-Howrah, State-West

Bengal, Pin-711322-

711322 04

-May

-93

M UR No Bakreswar

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

30

9008

16

5512

3

Masum Reza Kazi Md

Rezaul Karim

B-3, PRINCE DILAWAR

JAH LANE, P.O. AND

P.S. GARDEN REACH,

KOLKATA-700024

18

-No

v-9

4

M UR No Sattor PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

31

9018

66

5534

6 Mahadeb

Karan

Tarun Kumar

Karan

VILL-JARKASULI,P.O-

ANDHARIA, PS-

BINPUR,JHARGRAM-

721504

01

-Dec

-94

M UR No Bipratikuri

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

32

9009

48

5515

2 Mohammad

Sadique

Dr Hakim

Abdul Quadir

B-38/1/D, IRON GATE

ROAD, P.O. AND P.S.

GARDEN REACH,

KOLKATA-700024

30

-Au

g-8

9

M UR No Khujutipara

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Birbhum

33

9004

65

5503

8 Subha

Chattopadhy

ay

Samir

Chattopadhya

y

Manbariya Colony, Kulti ,

Kulti , Burdwan-713324

22

-Mar

-95

M UR No Khandra

Ukhra RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Bardham

an

34

9001

01

5494

1

Apala Sarkar Ashoke

Kumar Sarkar

H.R.B.C HOUSING

COMPLEX, BL-45,FLAT-

1,DUMURJALA,KADAM

TALA,HOWRAH-711101

08

-Au

g-9

5

F UR No Ghoshpur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

35

9024

62

5548

6 Motiur

Rahman Md Abbas

64,PHEARS LANE, PO-

C.R. AVENUE

KOLKATA -73-700073

03

-May

-84

M UR No

CCU,

Diamond

Harbour

GMCH

Service to be

utilized at Covid

Hospital

Diamond

Harbour

HD

36

9023

86

5546

4 Mulayam

Singh Yadav

Dashrath

Yadav

vill pawailodpur Post

saraimeer dist azamgarh-

276305

08

-Mar

-88

M UR No

CCU,

Diamond

Harbour

GMCH

Service to be

utilized at Covid

Hospital

Diamond

Harbour

HD

37

9007

32

5510

4

Pratyay Dey Pradip Kumar

Dey

BC-40, Samarpally,

Rajarhat Gopalpur(M),

North 24 Parganas,

Krishnapur, West Bengal-

700102 10

-No

v-9

3

M UR No

SNCU,

Medinipur

MCH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

38

9013

68

5523

9 Soumi

Midya

Asish Kumar

Midya

keranitola road,

midnapore, paschim

medinipur, west bengal-

721101

02

-Ap

r-94

F UR No

CCU,

Diamond

Harbour

GMCH

Service to be

utilized at Covid

Hospital

Diamond

Harbour

HD

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

39

9008

05

5512

0 Mayuri

Chatterjee

Santanu

Chatterjee

ANDUL SIDDHESWARI

TALA. P.O-

ANDUL/MOURI

DISTRICT -HOWRAH

PINCODE-711302-711302 08

-May

-94

F UR No

CCU,

Diamond

Harbour

GMCH

Service to be

utilized at Covid

Hospital

Diamond

Harbour

HD

40

9024

34

5547

9 Debraj

Chakrabortty

Durgadas

Chakrabortty

Vill- Sinhati, PO.-

Ramsagar, PS.- Onda,

Dist- Bankura-722147

12

-Ju

l-9

4

M UR No Ghoshpur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

41

9016

82

5531

5 Inadul

Ghatak Fazlul Ghatak

Vill- chamta

P.o- Goribpur

P.s- Gopalnagar

Dist- North 24 pgs

West Bengal-743710 05

-Oct

-94

M UR No Ghoshpur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

42

9019

34

5536

2 Rajarshi

Bhattacharyy

a

Sujit Kumar

Bhattacharyya

VILL- AMINPUR, PO-

KHAMARCHANDI, PS-

HARIPAL, DIST-

HOOGHLY-712405

02

-No

v-9

4

M UR No Taki RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

43

9024

41

5548

2 Anindita

Goswami

Subrata

Goswami

52/9 A.C.Road

Indraprastha Khagra

Berhampore Murshidabad

West Bengal-742103 08

-Jan

-95

F UR No Taki RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

44

9007

49

5510

6 Arka Provo

Mukherjee

Debasis

Mukherjee

12,GOSWAMI BAGAN

LANE.. PO-

SHEORAPHULI.. PS-

SERAMPORE.. DIST-

HOOGHLY..PIN-

712223..WB-712223

08

-Ap

r-95

M UR No Baduria RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

45

9000

57

5493

0 Rituparna

Paul

Prabir Kumar

Paul

B-13/80 FLAT NO. D-3

KALYANI JAMTALA

ROAD, PO AND PS-

KALYANI, DIST-

NADIA, PIN-741235-

741235

13

-Oct

-95

F UR No Masia PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

46

9006

50

5508

3 Debasmita

Mandal

Pankaj Kumar

Mandal

55/3/2 ANDUL

ROAD,LANDMARK-

OPPOSITE OF

CHRISTIAN CHURCH,

PO- DANESH SK. LANE,

HOWRAH- 711109-

711109

27

-Oct

-95

F UR No Jadurhati PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

47

9001

96

5497

5

Oindrila Sen Ratan Kumar

Sen

3Y,Naskar Para Lane,

Dhakuria, Kolkata-

700031-700031

18

-No

v-9

5

F UR No Rudrapur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

48

9001

52

5495

9 Arun Kumar

Gupta

Prabhash

Kumar

KURURIA DANGA,

AMRAI, DURGAPUR,

BURDWAN-713203

10

-Ju

l-9

1

M UR No Minakha RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

49

9024

55

5548

4

Riya Dhali Ranjan Dhali

BINOY GIRI

APARTMENT.

FARTABAD

MORE,GARIA STATION

ROAD. KOL-700084-

700084

10

-Oct

-91

F UR No Nimithi PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

50

9021

92

5462

3 Mukesh

Kumar Ramdev Rajak

AT - PACHRUKHI

PO - ITWA, VIA + PS :

DHARAHRA, MUNGER,

BIHAR-811212 23

-Jan

-92

M UR No Ghola PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

51

9001

69

5496

4 Md

Salahuddin Md Sayed

N.B.Gupta Sarani, South

Pirojpur, P.O. & Dist -

Malda, WB-732101

10

-No

v-9

3

M UR No Sandeshkhali

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

52

9010

08

5488

6 Md Taoquir

Shahanshah

Md Zafir

Hussain

C/O-MD ZAFIR

HUSSAIN

VILL-AIMONDIH

P.O- DIMDIHA,

PURULIA (W.B), 723103-

723103

01

-Jun

-94

M UR No Chakoltore

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

53

9013

64

5523

8

Joydeep Jana Durgasankar

Jana

M/ 52, MITRA

COMPOUND, PO-

MIDNAPORE, PS-

KOTWALI, DIST-

PASCHIM MEDINIPUR-

721101

22

-Ju

l-9

4

M UR No Jeliakhali

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

54

9002

02

5497

8 Abhirup

Midya

Bhudeb

Kumar Midya

Village : Rangibasan, P.S :

Mahishadal, Purba

Medinipur-721628

23

-Dec

-94

M UR No Sandeler Hill

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

55

9001

42

5495

6 Sudeb

Ranjan Paria

Gopal

Chandra Paria

VILL-

RAGHUNATHPUR, P.O-

BALICHAK, P.S-

DEBRA, DIST.-

PASCHIM MEDINIPUR,

STATE- WEST

BENGAL.-721124

07

-No

v-9

5

M UR No Sahebkhali

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

56

9016

02

5529

0

Arnab Dey Tapas Dey

VILL - MURALIBAR

(BAGAN PARA), P.O.

AND P.S. - BAGNAN,

DIST - HOWARH-711303

26

-Mar

-97

M UR No Nakuadaha

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

57

9005

67

5506

1 Shibabrata

Mukherjee

Jajneswar

Mukherjee

20/2 DR JAGABANDHU

BOSE LANE KOLKATA-

700009

15

-Ap

r-84

M UR No Nakuadaha

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

58

9024

99

5549

1 Md Sarfaraj

Ansari Tahir Hussain

Vill-shergram

P O- kogram,P S- nalhati

Dist-birbhum West

Bengal-731220 20

-Jun

-87

M UR No Rajendrapur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

59

9022

41

5542

4 Md Rashid

Quamar

Abdul

Quaiyum

S/O-ABDUL

QUAIYUM,VILL-

AGACHHIYA,PO-

CHANNI DORIA,PS-

AMOUR VIA-

BAISI,DIST-PURNIA-

854315 1

9-A

ug

-87

M UR No Bakra PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

60

9012

51

5521

5 Md Nazir

Alam

Md Jamil

Akhtar

VILL-DEHUTI, P.O-SB

TOLI, P.S-CHAKULIA,

DIST-UTTAR

DINAJPUR-733209

29

-Ap

r-92

M UR No CCU, Basirhat

DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

61

9003

37

5500

8 Mainak

Dutta

Aloke Kumar

Dutta

WARD NO 05,

ARAMBAGH,

ARAMBAGH,

HOOGHLY, WEST

BENGAL, 712601-712601 10

-Ap

r-94

M UR No CCU, Basirhat

DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

62

9020

51

5538

4

Apama Roy Ashim Kumar

Roy

8/2,UDBODHAN LANE

P.O -

BAGHBAZAR,KOLKAT

A-700003-700003 13

-Ju

l-9

4

F UR No Basirhat DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

63

9026

42

5551

8 Sourav

Singha Babu

Bharat Singha

Babu

Vill-Marlong,P.O.-

Simni,P.S.-Kotshila,Dist-

Purulia,PIN-723213,West

Bengal-723213

12

-Sep

-95

M UR No Basirhat DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Basirhat

HD

64

9002

78

5499

9 Saikat

Roychowdhu

ry

Santi Kumar

Roychowdhur

y

VIVEKANANDA PALLY

, P.O + P.S - SONARPUR,

KOLKATA - 700150-

700150 03

-Jan

-96

M UR No Ramjibnpur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

65

9005

79

5506

5 Miss Dipti

Mondal

Sri Surendra

Nath Mondal

18C/7 KABI SUKANTA

ROAD

SANTOSHPUR

KOLKATA-700075-

700075 18

-May

-96

F UR No Kukurdaha

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

66

9012

16

5520

5 Prasun

Kalyan Jana

Pijus Kanti

Jana

VILL-CHAKNAN,PO-

CHAKNAN,PS-

CHANDIPUR,DIST-

PURBA MEDINIPUR-

721633 23

-Ju

l-9

6

M UR No Khasbar PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

67

9001

48

5495

8 Sayeed

Anwar Alam

Rahamat

Alam

192, MG ROAD, POST -

CHINSURAH,

PS-CHINSURAH ,

DISTRICT- HOOGHLY

WEST BENGAL-712101 04

-Sep

-96

M UR No Makrampur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

68

9005

60

5505

9

Shaista Bano Md

Salahuddin

61G,topsia road kol-39-

700039

26

-Feb

-88

F UR No Basanchora

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

69

9018

75

5534

9 Shubhadeep

De

Hariprasanna

De

114 RAJDANGA

GOLDPARK PIYALI

APARTMENT 3RD

FLOOR, KASBA, EAST

KOLKATA TOWNSHIP-

700107

17

-Ju

l-8

8

M UR No Bhagabantpur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

70

9001

72

5496

6 Anupam

Kumar

Hare Krishna

Singh

C/O Sri H K Singh,

Asansol M Corp,

Gurunanak Pally Road,

Hirapur, Near Vaskar

Marriage Hall, Asansol (m

Corp.), Barddhaman, West

Bengal - 713301-713301

20

-Sep

-91

M UR No Khirpai RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

71

9027

84

5553

7 Murari

Kumar

Ram Uday

Mahto

AT+POST

KHANJAHANPUR

WARD NO 01 VIA

SIRIPUR DIST

BEGUSARAI BIHAR-

851132

22

-No

v-9

1

M UR No Sandipur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

72

9012

47

5521

4

Sandip De Satyajit De

VILLAGE+POST

OFFICE-MALDANGA

POLICE STATION-

MONTESWAR

DISTRICT-PURBA

BARDHAMAN-713145

01

-Feb

-93

M UR No Sandipur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Paschim

Medinip

ur

73

9023

54

5545

5 Aparna

Mukherjee

Udayan

Mukherjee

38 pratapaditya place

kolkata 700026-700026

07

-Oct

-94

F UR No Barnish PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

74

9016

39

5529

8 Shrabani

Shil Sudhir Shil

C/O-SRI SUDHIR SHIL,

SHREENIVAS , 73

MAHARAJA TAGORE

ROAD, DHAKURIA,

KMC, LAKE PS-700031 02

-Au

g-8

8

F UR No Looksan PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

75

9001

86

5497

2

Ayan Guha Amitava Guha 9A/17 South Sinthi Road.

Kolkata-700050

06

-Jun

-89

M UR No

Dhumpara

PHC, under

Sulkapara RH,

Jalpaiguri

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

76

9009

60

5450

5 Manish

Kumar

Hari Kishor

Paswan

AT PATHRA BARAHAT

BANKA BIHAR-813103

25

-Oct

-89

M UR No Looksan PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

77

9002

66

5499

3 Shailendra

Sharma

Sharan Kumar

Sharma

Sai Marg Road , Opposite

of Tenzin

Norgay Bus Terminus ,

Hotel Sharma-734003 14

-Oct

-90

M UR No Rangali PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

78

9025

45

5549

7 Anwesa

Banerjee

Keshab

Bannerjee

NSB Road, Paschim

Bardhaman

West Bengal-713347

17

-Mar

-91

F UR No Bhurunger

Bari PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

79

9001

64

5496

3 Sayantini

Ghosh Gopal Ghosh

A-9/108 Kalyani,Nadia

Pin-741235

West Bengal-741235

19

-May

-92

F UR No Saptibari PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

80

9015

90

5528

7 Monalisa

Mondal Barin Mondal

C/O-BARIN MONDAL,

PUSHPANJALI,

MASTER PARA,

KATWA-713130

23

-No

v-9

2

F UR No Belakoba RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

81

9013

14

5522

3 Ankur

Chakraborty

Tapas Kumar

Chakraborty

159/1,KABI SATYEN

DUTTA ROAD,P.O-

NIMTA,P.S-NIMTA,N 24

PGS,700049-700049

30

-Ap

r-93

M UR No Dhupguri RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

82

9024

15

5547

5

Saukat Ali Abdul

Mannan

Vill- Ghughumari, P.O-

Gitaldaha, P.S- Dinhata,

Dist- Coochbehar-736175

12

-May

-93

M UR No Panchelkuri

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Alipurdu

ar

83

9010

91

5518

2 Syed

Nizamuddin

Syed Abul

Fazal

VILL&P.O- GODAPARA

P. S- BURWAN

DIST-MURSHIDABAD

WEST BENGAL-742161

20

-May

-93

M UR No Panchelkuri

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Alipurdu

ar

84

9020

83

5539

3 Sayani

Pattanayak

Anup Kumar

Pattanayak

Village - Parbatipur, P.O +

P.S - Tamluk, District -

Purba Medinipur-721636

09

-Jun

-93

F UR No Madarihat RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Alipurdu

ar

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

85

9007

50

5510

7 Sattick

Chatterjee

Sitansu

Kumar

Chatterjee

138 gt road shree apt flat

902 block a-711102

22

-Oct

-93

M UR No Uttar Latabari

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Alipurdu

ar

86

9003

63

5501

3

Amit Singha Amal Chandra

Singha

Nabagram,Garia

P.O. Panchpota

Near Joy Kishori Park-

700152

20

-No

v-9

3

M UR No Madarihat RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Alipurdu

ar

87

9002

33

5498

6 Mostak

Shaikh

Azimuddin

Shaikh

vill Gazipur. post

Kashimnagar. P.s SUTI

.DIST MURSHIDABAD-

742224 09

-Jun

-94

M UR No

Anguldekha

PHC, under

Haldibari RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

88

9001

88

5497

4

Dipankar De Sibaji De

79/1, BHATTACHARYA

PARA AMBAGAN,

LALKUTHI,

BARRACKPORE,

NORTH 24

PARAGANAS-700120

14

-Au

g-9

4

M UR No

Balarampur

PHC, under

Natabari RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

89

9025

08

5549

3

Debasis Kar Jugal Kishore

Kar

B-13, KERANITOLA,

SINGHA COMPOUND,

STATION ROAD,

KERANITOLA

CROSSING,

MEDINIPUR(M),

PASCHIM MEDINIPUR,

MIDNAPORE, WEST

BENGAL, PIN-721101-

721101

23

-Jan

-95

M UR No Bamanhat RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

90

9011

11

5518

5 Mehedi

Hasan Molla

Md Mansur

Ali Molla

Vill+P.O-Battali, P.S-

Gosaba, South 24

parganas, WB-743611

23

-Ap

r-95

M UR No

Jamaldaha

PHC, under

Changrabandh

a BPHC,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

91

9024

36

5548

1 Rahul

Kumar Jha Manohar Jha

vivekananda nagar ,netaji

sarani ward no 42

salugara siliguri-734008

05

-Jun

-95

M UR No Haldibari RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

92

9016

49

5530

3 Arunika

Mishra Anjan Mishra

Flat no 5, PLOT NO-95

Antara apartment,

Jibanananda Das Nagar,

Brajanathchak , HALDIA

PURBA MEDINIPUR-

721605

13

-Oct

-95

F UR No Haldia SDH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purba

Medinip

ur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

93

9016

74

5531

3 Ambuj

Kumar

Thakur

Manoj Kumar

Thakur

P/M 915 MINER ROAD ,

BHUTNATH KOLE

ROAD , KANKINARA ,

BHATPARA ,

KANKINARA , NORTH

24 PGS. WB-743126

04

-Mar

-96

M UR No

Baxirhat

BPHC,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

94

9003

95

5502

3 Rupak

Kumar Jana

Dipak Kumar

Jana

VILL+PO-KHANCHI,PS-

NANDAKUMAR,

PURBA

MEDINIPUR,WB-721643 06

-Ju

l-9

1

M UR No

Kuchlibari

PHC, under

Haldibari RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

95

9015

93

5528

9 Ankan

Banerjee

Anup

Banerjee

43 JIBANANANDA DAS

PATH, SAIL

COOPERATIVE, CITY

CENTRE, DURGAPUR-

713216 29

-Jun

-94

M UR No

Nakarjaan

PHC, under

Sitai RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

96

9028

37

5554

1 Subhrangshu

Paul

Subhash

Chandra Paul

Ward-14, Ramsita Para,

Nabadwip, Nadia-741302

09

-Oct

-94

M UR No

Nayerhat

PHC, under

Bamanhat RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

97

9012

58

5521

7

Suvadip Jana Asit Kumar

Jana

2 NO RATANPUR,

NEAR 12 HAT

KALITALA, SINGUR,

HOOGHLY, WB ,

712409-712409 27

-May

-95

M UR No

Nishiganj

PHC, under

Goksadanga

RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

98

9020

21

5537

7

Dipan Sarkar Dr. Debasis

Sarkar

Shanti Apartment,

Ramkrishna Road,

Barddhaman, West

Bengal-713101

22

-Sep

-95

M UR No

Pakhihaga

PHC, under

Ashokbari

BPHC,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

99

9015

57

5528

1 Arpita

Batabyal

Goutam

Batabyal

UTTAR

PRATAPBAGAN,

SARANI NO. 11 ,

BANKURA, BANKURA

(SADAR), BANKURA-

722101-722101

18

-No

v-9

5

F UR No

Putimari-

Fuleswari

PHC, under

Dewanhat RH,

Coochbehar

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Coochbe

har

100

9001

78

5496

8 Saptarshi

Ganguly

Jayanta

Ganguly

MS-0316, BENGAL

AMBUJA CITY CENTRE

, DURGAPUR-713316

20

-Jan

-96

M UR No Gangarampur

SDH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

101

9016

31

5529

6 Adrijeet

Majhi

Arabinda

Majhi

Katjuridanga, Kenduadihi,

Bankura-I, Bankura, West

Bengal,-722102-722102

08

-Ju

l-9

7

M UR No Balurghat DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

102

9016

97

5531

8

Ria Roy Kanai Roy

2 NO SHANKHARI

PUKUR DIPTIBAG

WEST, P.O.-SRIPALLY,

PURBA BARDHAMAN-

713103 18

-Mar

-91

F UR No Balurghat DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

103

9016

44

5529

9 Fatima Tuz

Zohra

Ahamed

Hassan Imran

88/4 Jhowtala Road, 2nd

Floor-700017

22

-Oct

-91

F UR No Balurghat DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

104

9003

62

5501

2 Md Piyarul

Sk

Abdus Sattar

Sk

ABDUS SATTAR SK,

SRIRAMPUR,

MURSHIDABAD,WEST

BENGAL-742161-742161

04

-Mar

-92

M UR No Gangarampur

SDH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

105

9022

44

5542

6 Saradindu

Patra

Sailaja Kumar

Patra

Mohanpur, mohanpur,

paschim medinipur, west

bengal-721436

28

-Ju

l-9

2

M UR No Gangarampur

SDH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

106

9006

26

5507

7 Neda

Mohammed

Kazi Ghulam

Mohd

86,ripon street nirupama

apartment flat - 301-

700016

13

-No

v-9

2

F UR No Kumarganj

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

107

9001

23

5494

9

Abhik Saha Dr Asok Saha

120, SAHITYA SABHA

BYE LANE, WORD NO -

18, PO - COOCH BEHAR

, STATE - WEST

BENGAL-736101 04

-Ap

r-93

M UR No Rampara

Chechra PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

108

9010

44

5516

6 Pinaki

Chakrabortty

Ashok

Chakrabortty

Vill - Mawa,P.O.-Barachu,

P.S.-Kharagpur II,Paschim

Medinipur WestBengal,

India-721301

16

-Feb

-94

M UR No Hilli RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

109

9028

15

5553

9 Arvind

Morwal Arjun Lal

1009 DHOBIYON KI

MASJID SIKAR

RAJASTHAN 332001-

332001

05

-Ap

r-94

M UR No Hilli RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

110

9016

98

5531

9 Soumyajit

Biswas

Sourendra

Nath Biswas

66 , NIRANJAN NAGAR

, BLOCK - A, P.O- NONA

CHANDAN PUKUR ,

BARRACKPORE, DIST-

24 PGS (NORTH )-

700122

27

-May

-94

M UR No Harirampur

Rural Hospital

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

111

9012

17

5520

6 Subhajit

Sural

Dilip Kumar

Sural

VILL

BACHHURDOBA,PO+PS

JHARGRAM,DIST

JHARGRAM PIN NO

721507-721507 22

-Feb

-95

M UR No Harirampur

Rural Hospital

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

112

9001

10

5494

4 Abir

Chatterjee

Sukanta

Kumar

Chatterjee

219/1 A.C. ROAD,

BERHAMPORE

KHAGRA

MURSHIDABAD-742103

01

-Sep

-95

M UR No Kushmandi

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

113

9012

04

5520

2 Tinni

Mandal

Palas Kumar

Mandal

RAJIB PALLY, WARD

NO-16, DHULADANGA

ROAD,

SANGHATAPARA,

RAMPURHAT DIST-

BIRBHUM-731224

25

-Sep

-95

F UR No Nazirpur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

114

9025

83

5550

6 Riddhi

Chakraborti

Bishnu Kanti

Chakraborti

Flat no-12, 77/2,

Raimohan Banerjee

Road,Bonhoogly, ps-

Baranagar, Kolkata -

700108-700108 21

-Oct

-96

F UR No Trimohini

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

115

9005

85

5506

8 Yogesh

Kumar

Lakshmi

Narayan Ray

Roy tola, At+ PO Fulkaha

via Gamahariya, ward no

8, Madhepura, Bihar-

852124 05

-Oct

-84

M UR No Binsira PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

116

9028

40

5554

2 Soumyadeep

Manna

Dilip Kumar

Manna

242 AJC BOSE ROAD,

BLOCK-C, FLAT-2,

KOLKATA, WEST

BENGAL-700020

19

-Feb

-91

M UR No Samjhia PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

117

9023

00

5544

3 Suman

Chakraborty

Nabadwip

Chakraborty

VILL-KUSHPATA, P.O.-

GHATAL, P.S.-GHATAL,

DIST-PASCHIM

MEDINIPUR-721212

02

-Mar

-92

M UR No Deor PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

118

9003

02

5500

4 Sainnyak

Som Sisir Som

NIRVOYPUR,ARAMBA

GH,HOOGHLY-712601

16

-Oct

-92

M UR No Balihara PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

119

9010

17

5516

4 Abhirup

Bagchi

Asim Kumar

Bagchi

KK ROY SARANI,

RATHGHAR LANE,

ENGLISH BAZAR,

MALDA-732101 25

-Jan

-93

M UR No Aminpur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Dakshin

Dinajpur

120

9005

56

5488

0 Pritam

Debnath

Santosh

Debnath

186,Puratan office tilla.

P/O-Sabroom.P/S-

Sabroom.

Dist-South Tripura.-

799145 23

-Sep

-94

M UR No Raiganj RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

121

9010

05

5516

1 Chayanika

Mudi

Rabindranath

Mudi

SITALA RESIDENCY

FLAT NO 302

KALYANPUR HOUSING

ROAD NEAR MELA

BURI MANDIR PO RK

MISSION PS ASNASOL

NORTH DIST PASCHIM

BARDHAMAN-713305

28

-Au

g-9

5

F UR No Chakulia RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

122

9019

76

5537

0

Sayan Ghosh Swajan

Kumar Ghosh

CHUANPUR, LOKNATH

PALLY, BERHAMPORE,

P.O.+P.S.-

BERHAMPORE (WB),

MURSHIDABAD, WEST

BENGAL-742101

06

-Sep

-95

M UR No Kanki PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

123

9016

06

5529

1 Suchismita

Datta Manik Datta

41, BOSEPUKUR ROAD,

FLAT NO- 2B,

HASTINGS TOWER,

KASBA, KOLKATA-

700042 11

-Dec

-95

F UR No Lakshmipur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

124

9025

17

5549

4 Abhishek

Roy

Basabendra

Roy

CITY DECORATORS,

RABINDRANGAR,

SILIGURI,

Dist.: DARJEELING-

734006 17

-Sep

-92

M UR No Sujali PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

125

9010

66

5517

5 Sainik

Adhya

Soumen

Adhya

DEARAPARA GHAT

ROAD, P.O.-

NABADWIP, P.S.-

NABADWIP, DIST-

NADIA-741302 05

-May

-93

M UR No Panjipara

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

126

9005

97

5507

0 Himjit

Ghosh

Mahadeb

Ghosh

KURCHIPOTA LANE,

KRISHNAGAR -

1,KRISHNANAGAR,

NADIA, WEST BENGAL,

741101-741101 26

-May

-93

M UR No Rasakhoa

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

127

9015

07

5526

9 Aritra

Kumar

Ghosh

Paritosh

Kumar Ghosh

Netajipally,Uttar

Dinajpur,Raiganj,Pin-

733134-733134

05

-Sep

-93

M UR No Bangalbari

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

128

9006

69

5508

9 Suman

Hazra

Late Barun

Hazra

VILL. + P.O.-

JAGATBALLAVPUR

DIST.-HOWRAH,WEST

BENGAL-711408 24

-Jan

-94

M UR No Durgapur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

129

9000

09

5492

0 Arpita

Sarkar Arup Sarkar

Vill- Banipur, Po- Miapur,

Ps- Raghunathganj, Dist-

Murshidabad-742235

03

-Mar

-94

F UR No Bangalbari

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

130

9022

80

5543

4 Sreyoshi

Banerjee

Sibasish

Banerjee

MOKDUMPUR,

SHAHJAHAN

RESIDENCY, 5th

FLOOR, MALDA, WEST

BENGAL.-732101 07

-Mar

-94

F UR No Surun PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

131

9015

32

5527

4 Shankhadeep

Banerjee

Debasish

Banerjee

C/O DEBASISH

BANERJEE,BARJORA(O

PP TO UBI),DIST-

BANKURA,WEST

BENGAL-722202-722202 05

-Jun

-94

M UR No Churamon

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

132

9015

89

5528

6 Soubhik

Sinhababu

Pradip

Sinhababu

VILL-RAMNAGAR, PO-

LAYEKPARA,

SIMLAPAL, BANKURA,

WEST BENGAL-722151

12

-Sep

-94

M UR No Bararail PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

133

9013

99

5525

1 Sagarika

Chatterjee

Saibal

Chatterjee

Ramkrishna

Road,Khoshbagan,Purba

Bardhaman,Burdwan-

713101

20

-Sep

-94

F UR No Itahar RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

134

9014

33

5525

9

Oindrila Das Dilip Kumar

Das

THE NEST

GIP COLONY HOWRAH

NEAR TOSH HOUSE-

711112

21

-No

v-9

4

F UR No Lodhan RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

135

9010

06

5516

2 Manipushpa

k Bhadra

Uchhal Kumar

Bhadra

B-23 Jayashree Park,

Behala Kolkata 700034-

700034

02

-Sep

-95

M UR No

Bhatoon PHC,

Raiganj

BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

136

9009

51

5515

3 Tabassum

Haque

Md. Ajijul

Haque

VILL +PO. NORTH

KANCHDAHA PS.

SWARUPNAGAR

DIST.24 PARGANAS

(NORTH) WEST

BENGAL-743286

15

-Oct

-95

F UR No Chakulia RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

137

9013

38

5523

2

Saikat Patra Narendranath

Patra

VILL-RAJHATI,PO-

HARIDASPUR,PS-

TAMLUK,DIST-PURBA

MEDINIPUR,PIN-

721653-721653 23

-No

v-9

5

M UR No Goagaon PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

138

9015

34

5527

6 Partha

Sarathi Jana

Ajit Kumar

Jana

Gorkhara Mondal para ,

Rajpur Sonarpur (M),

South 24 Parganas

,Sonarpur, West Bengal-

700150 15

-Ap

r-96

M UR No Majhiar PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

139

9014

41

5526

1 Richik

Sarkar

Pallab Kumar

Sarkar

A-27,NANDAN

KANAN,SANTOSHPUR,

KOLKATA-700075

23

-Jun

-96

M UR No Dalua RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

140

9015

33

5527

5

Srijita Ghosh Krishna Pada

Ghosh

G-6, Rabindrapally,

Baguiati, Jyangra,

Rajarhat, North 24

Parganas-700059

15

-Ap

r-91

F UR No Karandighi

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

141

9009

52

5515

4 Sk Musrail

Rahaman

Sk Masiar

Rahaman

vill-lankajol po-sihar ps-

kotulpur dist-bankura

State-westbengal-722161

04

-Mar

-93

M UR No Kunor BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Uttar

Dinajpur

142

9010

29

5516

5 Ram Gopal

Ghosh

Asit Kumar

Ghosh Bali dewan ganj-712616

29

-Mar

-93

M UR No Ghoom TB

Hospital

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

143

9009

27

5514

7 Suranjana

Dutta

Dilip Kumar

Dutta

CHAKBHABANI KALI

BARI PARA, NEAR

MATRI SADAN,

P.S.+P.O.-BALURGHAT,

DIST-DAKSHIN

DINAJPUR-733101

31

-Oct

-94

F UR No Karseong

SDH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

144

9012

53

5521

6

Tamal Basak Nripendra

Nath Basak

62-PRANKRISHNA

SARANI, SUKANTA

NAGAR, SILIGURI,

DIST: JALPAIGURI,

WEST BENGAL.-734006 19

-Feb

-95

M UR No Karseong

SDH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

145

9023

66

5545

9 Asmita

Chakrabarti

Dilip Kumar

Chakrabarti

AD- 196 (1ST FLOOR),

RABINDRA PALLY,

KESTOPUR, P.O -

PRAFULLA KANAN,

DIST : NORTH 24

PARGANAS , WEST

BENGAL - 700101-

700101

18

-Mar

-95

F UR No Bagora PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

146

9009

22

5514

4

Srijani Roy Dr.Parthasarat

hi Roy

FLAT NO.1F 901,

AVIDIPTA HOUSING

COMPLEX, 401

BARAKHOLA, NEAR

METRO CASH AND

CARRY,

MUKUNDAPUR,

KOLKATA-700099-

700099

07

-Ju

l-9

5

F UR No Singingtong

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

147

9010

16

5516

3 Ayush

Shukla

Dr. B.B.

Shukla

60/3, ANDUL FIRST BYE

LANE

DANESH SHEIKH LANE

CHIRANTANI PARA

HOWRAH-711109 10

-Oct

-86

M UR No Bijanbari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

148

9003

26

5500

5 Manish

Sharma

Rajesh

Sharma

101,government hospital

road ,raniganj

dist - burdwan( west

bengal) 713347-713347 13

-Jan

-89

M UR No Tagda RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

149

9020

05

5537

4 Madhurima

Roy

Asoke Kumar

Roy

Lalkuthi para, Suri,

Birbhum-731101

09

-May

-91

F UR No Bijanbari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

150

9020

12

5537

6 Avik

Bandyopadh

yay

Arun

Bandyopadhy

ay

F/5 Anandapuri,

Barrackpore, 24 parganas

north west bengal-700122

16

-Au

g-9

1

M UR No Siliguri DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

151

9014

28

5525

7 Subinita

Misra Subrata Misra

51/A/121, 1 No. Govt.

Colony( near Kali Mandir)

, English Bazar , Malda ,

West Bengal-732101 11

-Jun

-93

F UR No Darjeeling DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

152

9005

30

5504

9 Shreya

Jaiswal

Sanjiv Kumar

Jaiswal

35 Karbala Tank Lane

Burtolla Beadon street-

700006

12

-Oct

-93

F UR No Kharibari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

153

9002

52

5499

1 Jainendra

Kumar

Achhayalal

Yadav

C/02/08, JHANJRA

OFFICERS COLONY PO

, LAUDOHA ,

FARIDPUR-713385

20

-Dec

-93

M UR No Takda RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

154

9025

81

5550

5 Tapas

Kumar

Mukherjee

Smriti Chand

Mukherjee

VILL. + P. O. -

DASGHARA ,

P. S. - DHANIAKHALI ,

DIST. - HOOGHLY-

712402 15

-Jun

-94

M UR No Phansideoa

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

155

9004

36

5503

4 Akash

Banerjee

Sudipta

Banerjee

19/1B MADHUPUR

ROAD(PARTLY),PROFE

SSORPARA,

CHRISTIANPARA(PURB

O) ,BERHAMPORE,

MURSHIDABAD, WEST

BENGAL-742101

07

-Jan

-95

M UR No Naxalbari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Darjeelin

g

156

9024

69

5548

8 Sushovan

Das

Ujjal Kumar

Das

Sahara, P. O. - Pransagar,

Dist- Dakshin Dinajpur-

733140

07

-Jan

-95

M UR No Jsypur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

157

9015

91

5528

8 Sreemedha

Choudhury

Avijit

Choudhury

FLAT NO. 632 , GOLF

VISTA APARTMENTS,

SECTOR ALPHA 2,

GREATER NOIDA,

UTTAR PRADESH-

201310

20

-Feb

-95

F UR No Pathardih RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

158

9018

09

5533

1 Poushali

Samanta

Ashok Kumar

Samanta

Ramkrishnapally , P.O.-

Inda, P.S.- Inda (T),

kharagpur, Dist- Paschim

Medinipur, Pin- 721305-

721305 28

-Mar

-96

F UR No Sirkabad RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

159

9004

44

5503

6

Shreya Pal Uday Kumar

Pal

1/14, UDAY SANKAR

BITHI, CITY CEN TRE,

DURGAPUR, DIST:-

PASCHIM

BARDDHAMAN, PIN:-

713216-713216 1

0-A

ug

-96

F UR No Bansgarh RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

160

9016

58

5530

6

Subid Ghosh Sunil Kumar

Ghosh

16/1, kabi chandi charan

mitra street kolkata-

700056-700056

27

-Sep

-91

M UR No Barabazar RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

161

9015

74

5528

4 Syed Arif

Ahmed Syed Md Ali

OLD DANGAL PARA

PURATAN LINE PO

SURI PS SURI DIST

BIRBHUM-731101 03

-Oct

-91

M UR No Bandowan RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

162

9027

70

5469

3 Ravishekhar

Kumar Ravi

Shailendra

Paswan

AT-CHHOTI CHAK, PO-

JAMALPUR, P.S.-GOGRI

JAMALPUR, DIST-

KHAGARIA-851203

25

-Sep

-93

M UR No Bari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

163

9013

88

5524

7 Jasmin

Ghale

Keshar Singh

Ghale

10th mile ,opposite dharma

buddha ashram,lower

gumba hatta ,Kalimpong

dist, West bengal-734301

01

-No

v-9

3

F UR No Manbazar RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

164

9000

50

5492

9 Sunetra

Ghosh

Lakshman

Ghosh

Deulpara,dedhara,Hooghly

,west bengal-712302

23

-Au

g-9

4

M UR No Hura RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

165

9020

81

5539

1

Abrar Alam Md Sanaullah

VILL-JOYRAMPUR ,

PO-BHABANIPUR , PS-

FARAKKA , DIST-

MURSHIDABAD ,

WESTBENGAL-742202 02

-Feb

-95

M UR No Harmadih RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

166

9010

03

5516

0 Anupam

Aich

Prasanta

Kumar Aich

Dabor

More,Rupnarayanpur,P.O.-

Rupnarayanpur

Bazar,Dist.-Paschim

Barddhaman-713386 06

-Sep

-95

M UR No Bari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

167

9020

43

5538

1

Simple Seal Satyajit Seal

58/84 PRINCE ANWAR

SHAH ROAD

LAKE GARDEN-700045

26

-Feb

-96

F UR No Bari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

168

9015

25

5471

8 Nelufar

Begum

Late Faiz

Mohammed

POLICE LINE NEAR

POLICE CANTEEN,

POST OFFICE

JUNGLIGHAT, SOUTH

ANDAMAN AND

NICOBAR ISLANDS

PIN-744103-734012 2

2-O

ct-8

4

F UR No Banda RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

169

9018

57

5534

3 Dhiman

Bhattacharya

Biplab

Bhattacharya

4 Tilak Road,Flat 2B-

700029

17

-Oct

-88

M UR No Kustaur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

170

9002

20

5498

2 Ritabrata

Bhowmik

Haran

Bhowmik

AT-DAKSHINPARA,

CIRCULAR ROAD, P.O.-

BIRNAGAR, P.S.-

TAHERPUR, DIST-

NADIA, WB-741127 04

-May

-92

M UR No Chakoltore

RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

171

9006

67

5508

8

Asha Mishra Ashok Mishra

VIDYASAGAR ROAD,

SILIGURI (M CORP.),

SILIGURI, DISTRICT-

DARJEELING.-734005

26

-No

v-9

2

F UR No Jhalda RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

172

9014

20

5525

4

Suraj Saha Sanar Saha

VILL-SHAL TILLA,P.O-

BELONIA,DIST-SOUTH

TRIPURA,STATE-

TRIPURA,PIN-799155-

799155 24

-May

-93

M UR No Jaypur BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

173

9022

84

5543

8 Sreya

Chatterjee

Rabindra

Prasad

Chattopadhya

y

229,ghatak

para,monirampur,barrackp

ore,north 24 parganas,west

bengal.-700120

21

-Au

g-9

3

F UR No Baragram

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

174

9000

20

5492

4

Pingal Roy Pranab Roy

Belakoba,Prodhanpara,

Prasannanagar,Jalpaiguri,

West Bengal-735133

14

-Ap

r-95

M UR No Chakoltor RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

175

9022

22

5491

1 Devi Sri

Nelli

Nelli

Narayana Rao

D NO- 3/F, 3rd FLOOR,

MOUCHAK

APARTMENT, 333/I,

JESSORE ROAD,

KOLKATA- 700089-

700089

21

-Mar

-96

F UR No Kustaur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

176

9023

70

5546

1 Souvik

Goswami

Bidyut

Goswami

Vill-parulia more,p.o.-

gargaria,p.s.-sarenga,dist-

bankura-722150

07

-May

-96

M UR No Banda RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

177

9022

97

5544

2

Sahana Khan Aditya Kumar

Khan

SURYA SEN PALLY,

WARD NO.5,

ARAMBAGH,

HOOGHLY, WEST

BENGAL-712601 20

-Ju

l-9

6

F UR No Harmadih RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

178

9009

06

5513

8 Som Subhra

Chaudhury

Sailendranath

Chaudhury

280/2 SHYAMA

PRASAD PALLY,

NASRAPARA LANE,

P.O.- RANAGHAT,

DIST- NADIA, WEST

BENGAL-741201

10

-Feb

-97

M UR No Raibandh

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

179

9018

44

5534

0 Abhijit

Mondal

Ajoy Kumar

Mondal

GRAM-

HOSPITALPARA,BATAI

L(ANGSH),RAMPURHA

T,BIRBHUM-731224

26

-Feb

-97

M UR No Hura PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

180

9006

60

5508

6 Loknath

Kumar

Baikunth

Prasad

VILL NINGHA

COLOWARY NEAR

SHIV MANDIR .P.O

NINGHA P.S JAMURIA

DIST PASCHIM

BARDHAMAN PIN

713370-713370

26

-Sep

-86

M UR No Puncha RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

181

9011

94

5520

0

Ekrama Sk Sk Iklas Ali

NIMDIGHI ULUBERIA

HOWRAH 711316-

711316

17

-Jan

-92

F UR No Manbazar RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

182

9019

57

5536

7

Ananda Pal Late Dulal

Chandra Pal

VILL+P.O.-

BARAIBARH,P.S.-

BHAGWANPUR,DIST-

PURBA

MEDINIPUR,PIN-

721626-721626

18

-No

v-9

3

M UR No Bari RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

183

9010

46

5516

7

Shahid Shamshad Ali

VILL-P.O.-AHIRAULI

BAZAR, P.S.-KASIA,

DIST-KUSHINAGAR,

UP-274402 01

-Ju

l-9

4

M UR No Bandowan RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

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Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

184

9020

64

5538

5 Anindya

Chakraborty

Bablu

Chakraborty

Vill+P.O+P.S-PARA,Dist-

Purulia-723155

08

-Jun

-95

M UR No

Dhumpara

PHC, under

Sulkapara RH,

Jalpaiguri

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

185

9020

06

5537

5

Pranay Das Nikhil

Chandra Das

VILL+PO-TORYAL,PS-

CHAKULIA,DIST-

UTTAR DINAJPUR-

733208

19

-Feb

-96

M UR No Dhupguri RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

186

9008

73

5513

3 Kumari

Supriya Rani

Hari Narayan

Panjiyar

VILL-LITIYAHI, P.O-

DINAPATTI, P.S-PIPRA,

DIST-SUPAUL-852218

12

-Feb

-91

F UR No Sankoajhora

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

187

9000

58

5493

1 Siddharth

Kataruka

Mohan Kumar

Kataruka

21 A, CHAIBASA ROAD,

ZILLA SCHOOL MORE,

PURULIA, WEST

BENGAL-723102

01

-Feb

-92

M UR No N Goalmari

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

188

9008

08

5512

1

Isita Jana Isanath Jana Jhorhat andul mouri

howrah-711302

21

-Au

g-9

2

F UR No South

Berubari PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

189

9012

79

5521

9

Arnab Jana Pratap Kumar

Jana

Vill - Gonara, Golara Nij,

Manglamaro, Potashpur 1,

Purba Medinipur, West

Bengal-721434

30

-Ap

r-95

M UR No Bahadur PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

190

9012

41

5521

1 Nabanita

Nath Sajal Nath

MANBERIA SUKANTO

PALLY BARAKAR-

713324

13

-Oct

-95

F UR No Karnasubarna

BPHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Murshid

abad

191

9023

84

5464

5 Laxmi Kant

Bhaskar Gaya Prasad

65 BHISI JARGAON

DHARMANGAD PUR

BHAUTHI KANPUR

NAGAR-208022

22

-No

v-8

8

M UR No Mal SSH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

192

9017

09

5532

0 Ashish

Kumar

Dharmraj

Singh Yadav

ECHWAL NEWADWA

POST:RAMPUR

DIST:GAZHIPUR,

UTTAR PRADESH-

233223 20

-Oct

-90

M UR No Mal SSH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

193

9022

32

5542

1 Ikbal

Hossain

Shaikh

Jakir Hossain

Sk

VILL.- MIRA MATH

PARA , P.O.- PLASSEY ,

P.S.- KALIGANJ , DIST.-

NADIA , WEST

BENGAL-741156 31

-Ju

l-9

2

M UR No Mal SSH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

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Page 24

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

194

9022

59

5543

0

Pubali Dey Panchanan De

Mahokumar hospital

(Asansol Dist Hospital),

ASANSOL ,Paschim

Bardhman .-713301

03

-Mar

-95

F UR No Mal SSH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

195

9022

63

5543

2 Jayita

Ghatak

Durgadas

Ghatak

RAGHUNATHPUR, 227

BARAKAR ROAD,

NEAR SBI, DIST-

PURULIA. WEST

BENGAL. PIN-723133-

723133

15

-Mar

-96

F UR No Mathachulka

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

196

9022

18

5541

7 Arindam

Samui

Asis Kumar

Samui

Vill.-ChandrakonaRoad,

Dist.-paschim Midnapore-

721253

11

-May

-94

M UR No Brabazar RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

197

9020

72

5538

9 Shreya

Biswas

Sriranjan

Biswas

26, BAITHA KHANA

ROAD, SEALDAH-

700009

03

-Au

g-9

4

F UR No Bansgarh RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

198

9016

69

5531

1 Ashwin

Singhania

Sanjay Kumar

Singhania

SARKAR KUMAR TULI

BIDHANNAGAR,

BARO PAIK PARA,

BUDHARUGAON,

MADATI, DARJILING-

734426

02

-Au

g-9

5

M UR No Sirkabad RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

199

9000

27

5492

6 Alapan

Bhattacharyy

a

Alapan

Bhattacharyya

Rabindranagar Susinda

Shashinda Belda

Narayangarh Paschim

Medinipur-721424

12

-Feb

-95

M UR No Pathardih RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

200

9023

47

5545

3 Sampad

Behura

Sarat Chandra

Behura

1B/1 Akbar Road,

Durgapur-713204

07

-May

-96

M UR No Kustaur RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

201

9012

36

5520

9 Haraprasad

Mandal

Pabitra

Mondal

Beltola

Khantura

Gobardanga(m)

Khantura

North 24 Parganas

West Bengal -743273-

743273

10

-Jun

-91

M UR No Chakoltor RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

202

9025

71

5466

7 Chandra

Gaurav

Shankar

Paswan

S/O Shankar paswan,

uphraul,Ufraul,vaishali,bih

ar-844504

31

-Mar

-93

M UR No Turturi PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Alipurdu

ar

Page 25: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 25

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

203

9018

43

5533

9 Subhankar

Paul

Raghu Nath

Paul

14/4, G.T. ROAD, BOSE

PARA LANE,

BAIDYABATI,

BHADRESHWAR (P),

HUGLI, WEST BENGAL,

712222-712222

05

-Jun

-94

M UR No Kalimpong

DH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Kalimpo

ng

204

9021

14

5539

7 Suvojit

Banerjee

Ranajit Kumar

Banerjee

KANSARIPARA, P.O. -

DAINHAT, P.S. -

KATWA, DIST. - PURBA

BARDHAMAN-713502 15

-Jun

-94

M UR No Moulani PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

205

9022

83

5543

7 Tuhin

Subhra

Konar

Tapan Kumar

Konar

VILL -

BALSI(HARIPUR), PO -

BALSI, DIST -

BANKURA-722206

02

-May

-95

M UR No

Uttar

Saripakuri

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

206

9016

19

5529

4 Rathindra

Nath Basak

Dhruba Ch

Basak

RAMHARI MORE,

WARD N0. 6, P.O.

TUFANGANJ, DIST -

COOCH BEHAR-736159 24

-Ju

l-9

6

M UR No Mal SSH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

207

9004

84

5504

1 Debsankar

Bhattacharya

Rabisankar

Bhattacharya

DAKSHINPARA

BOXIBAZAR

MIDNAPORE P O

MIDNAPORE

DISTRICT PASCHIM

MEDINIPUR

STATE WEST BENGAL

PIN 721101-721101

17

-Jun

-88

M UR No Saktibari PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

208

9018

23

5533

4 Kumarjyoti

Sarkar Dipak Sarkar

KUMARJYOTI SARKAR

,COURT ROAD WARD

NO-6 NEAR BUS

STAND , ARAMBAGH ,

HOOGHLY ,WEST

BENGAL-712601

07

-No

v-8

6

M UR No Chura

Bhandar PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

209

9001

12

5494

6

Elias Molla Tajem Ali

Molla

7 no. kumrakhali (sarberia)

F.S.hat , Basanti

south 24 parganas-743329

10

-Jan

-90

M UR No Shikarpur

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

210

9027

29

5552

8

Raj Gaurav Gyan Chandra

Prasad

BHARAT KUTTY

MILL,KHALPARA

SILIGURI,DIST

DARJEELING-734005

25

-Mar

-90

M UR No Kukurjan

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

211

9026

97

5552

5

Swarnali Hui Sankar Hui

VILL+PO-KESHIARY

DIST-PASCHIM

MEDINIPUR-721133

31

-Ju

l-9

2

F UR No Koreng PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Purulia

Page 26: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

Page 26

Annexure A to Memo No. HF/O/HS(MA)/1427/SF-23/2020/HPT/32M-59-20 dated 22nd October 2020

Sl.

No.

Reg

n. ID

Ro

ll N

o.

Name Father's

Name Address

Da

te o

f B

irth

Gen

der

Ca

tego

ry

PH

Places of

posting as

General Duty

Medical

Officer at

Service to be

utilized at District

[A] [B] [C] [D] [E] [F] [G] [H] [I] [J] [K] [L] [M]

212

9013

34

5523

0 Arindam

Maiti

Chittaranjan

Maiti

VILL:TILANDA,

PO:BALAKROUTH,

DIST:WEST

MEDINIPUR-721146

21

-Dec

-93

M UR No Duramari

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

213

9023

36

5545

0 Abhijit

Kumar Sinha

Yogendra

Prasad

YOGENDRA PRASAD

MOH-DHIRACHAK,P.O-

ANISABAD

DISTRICT-PATNA-

800002 08

-Sep

-89

M UR No Jharaltagram

PHC

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

214

9022

48

5542

7 Arjun Kumar

Basu

Durjoy Kumar

Basu

C/O DR. DURJOY

KUMAR BASU

PIROJPUR,

SANTI GOPAL SEN

SARANI

MALDA-732101 3

0-O

ct-9

1

M UR No Belacoba RH

Service to be

utilized at Covid

Hospital in the

district by

CMOH

Jalpaigur

i

Page 27: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

PoliceVerification RollPassport

sizephotograph

1. Name in Full (In block capitals) with aliases,if any. (Please indicate if you have added ordropped, at any stage, any part of your nameor surname).

Surname Name

2. The name of the post and service applied for

3. Present address in full (i.e. village, thana anddistrict or house number, lane/street and road,PIN)

4. (a) Home address in full (i.e. village,thana and district or house number,lane/street and road, PIN)

(b) If originally a resident of Pakistan,Bangladesh, Nepal or any othercountry, the address in that dominionof migration to Indian Union.

5. Particulars of places where you have resided for more than one year during the preceding five years

From To Residential address in full (i.e. village, thana and district orhouse number, lane/street and road, PIN)

6. (a) Father’s name in full with aliases, if any … (a)

(b) Present Postal address (if dead, give the last address) … (b)

(c) Permanent home address … (c)

(d) Profession … (d)

(e) If in service, give designation and official address … (e)

7. (i) Nationality of—(a) Father … (a)(b) Mother … (b)(c) Husband … (c)

(d) Wife … (d)8. (a) Exact date of birth … (a)

[To be supported by Birth Registration Certificate/Admit Cardof West Bengal Board of Secondary Education/any otherRecognized Board](b) Present age … (b)(c) Age of Matriculation/School Final …(c)

9. (a) Place of birth, district and State in … (a)which is situated

(b) District and State to which you belong …(b)

Annexure B

Page 28: Government of West Bengal Department of Health and ......Page 1 Government of West Bengal Department of Health and Family Welfare Swasthya Bhavan, GN-29, Sector-V, Health Services

2

10. (a) State your religion

(b) Are you member of scheduled caste/ Scheduledtribe/ OBC. Answer “Yes” or “No” and if theanswer is “Yes” state the name thereof. [Copy ofcertificate to be attached]

11. Education qualifications showing place of education with year in school colleges:

Name of school/colleges with full address Date of entering Date of leaving Examination passed

12. If you have at any time been employed give details

Designation of the postheld or description ofwork

Period Full address of the office, firm orinstitution and reasons for leavingprevious service

13. Have you ever been convicted by a Court of anyoffence or charge-sheeted by the police in connectionwith any criminal proceeding? If so, the fullparticular of the case should be given.

14. Name of two responsible persons of your locality (1) ………………………………………….. or

two referees to whom you are known (2) …………………………………………..

I certify that the foregoing information is correct and complete to the best of my knowledge and belief. I am not aware of mycircumstances, which might impair my fairness for employment under Government. I understand that submission of false informationwill make me ineligible for employment.

Date…………………. Signature of the candidate……………………………………………Place………………….

(Certificate to be signed by a gazetted officer)

Certified that I have known Shri/Shrimati…………………………………………………………… son/daughter ofShri……………………………………………………….. for the last……………………… years ………………months and that tothe best of my knowledge and belief the particulars furnished by him/her are correct.

Place……………. Signature…………………………………………………. Date…………….Designation status and address……………………………

…………………………………………………………….

Signature and designation of the Issuing Officer and the nameof the office with full address and date.