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F'N0.16150/Genterized inorsRVE-A.NH2016/ | 2.2 41 Dated: 4/08/2017
WALK INN} loTice
Senter Rene Wit be held as per the schadule given below in LNH in connection wih filing up the vacant
Pe atnicsie oanten's on purely adhe basis in the pay matic oflevelt} at Re arr other usual allowances
8 admissible under rules
Vacaney Position:- 5 Nee eS
[SLNo. | Namo ofthe Deparinent | Vaeaney [Date ® Pace oF interview —]
[1 Tranesthesia | 21 2ia017 Room. toy
Bio-cramisty —12aroe2017 room No-007
Blood Bank einer
| Patnoiogy |—1___[ 221082057 FRoom No. OoT
‘The number of vacancy may vary on the dale ofinfenvooe
Beearabhe Soi be submited between 08:30 AM to 11:00 AM ov the cote Interview in the office of Addl Medical
rat ha ret Rc2m no. 006, Admiisatve Block LNH. Cenddatos se sey {0 appear at 01:30 PM in
ffortot Board atthe date & venue mentioned above, along wir the following original documents.
‘AS ber the Health and Family Weare circular no, F No 121/26/2010/&FWIDSHFW/1096-2045 dated 10/6/11
a2 o8 lit fr ely wit be 40 yeare in pace of existing sarees years in case the fresh candidates are not
siamable and even tho cancidates who have completed 3 years of residency but are wiling to serve as residents are
cand enna a ntrviow. A separto ment ist fr es canadeee se ‘others would be prepared and the
appohincr ence OY Selected subject to the sutaity se par other ane Conditions. The senior residents
8ppoiniments under the relaxed criteria willbe for Ot year
(ole aitment shall be made scty a8 per the Residency Scheme ae Sheulated by Department of Health &
Famly Wellace, GNCTD
sine ede of selection wil be by intervew (Viva Voie), Incase of ‘any change in the mode of selection, the
‘Same willbe uploaded on the website of LNH,
fre catcdates_are_advised 10 visit the website of L k_Hosotial_on_reqular_basis_ie
Mikel oy nivosiver/connectDolT LNJP/nihoma Gonkeia mn. if any wil be displayed on this website
The format of application form is enclosed herewith i fe
(Or. S.K Bansal)
‘Addl. MS (Admn,)
Copy to:-
Oran MAM Orecior GIPMER, Dvector GNEC, MD ODUM, MD GTBH nd MD BSAH with the request to get the
alice cisolayed on Notice Board
2.PStoMO, LNH
3 Notice Boara of AMS (A), LNH
PIO Mapa acces encima gi i Fw Dept, aNCTO
SHOP Avesvesi, HOD Bto-choiary, HOD Blood Bank and NOD PatonAPPLICATION FOR TH)
POST OF SET
OR RESIDENTS ON ADHOC BASIS IN LNH
SPECIALITY | = Affix Latest
pets oe = Passport Size
(lease tick whichever is applicable)
PH
1. Name of Applicant (in block eters)
2, Father's / Husband’s Name
3. Date of Birth
4, Residential Address Permanent
Local
5, Contact (Phone No.) (),
6, Email 1D
‘1. Valid DMC Registration Number with
Date for concemed speciality
8, Academic Qualification
Photograph on
White
Background
AR).
Qualification Year of Board/University
passing
Number oFatter pts
MBBS I" prof,
MBBS 2nd prof
MBBS 3rd! prof.
MBBS 4th prof
PG DegreelDiploma
(09, Whether worked as Senior Resident on regular /Ad-hoe basis:
Nase of ation Period of appoint
‘Specialty in which wcerape
10, Experience (ifany) after PG
11, Details of Publications
10, Conference Attended Presentation:
13, Any addtional information
Declaration:
I solemnly declare that above statements made by me are true and correct to the best of my knowledge and
belief
Dated:
Place: (SIGNATURE OF APPLICANT)
Enclosure:-
(Enclose as per following order)
Please tiek in the box
1. Copy of Date of Birth Certificate fees
2 Copy of Caste Certificate if applicable rT
Copy of PH Certificate if applicable
4, Copy of valid DMC for PG Degree/DNB/Diploma
5 Copy of attempt certificate of MBBS No. of attempts feast
6 Copy of attempt certificate of PG Degree/DNB/Diploma [___]
7. Copies of publications
8, Any other awards/Distinction