c{i1 ~l~"I atl<ailll atfi:l"IM (~ ;iq~ "II \ff ~ , a11 ~'"I lr.n', ' 11 nl 'Ii 1'6aJ 1 ;i1 nl ;ii 't (ti) 51'1actl

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

~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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Oliitil

nashik1 nuhmddhsnsk@gmail.com ~ ;., ..

/ . ),

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 ~

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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.

c{i1 ~l~"I atl<ailll atfi:l"IM (~ ;iq~ "II \ff ~ , a11 ~'"I lr.n', ' 11 nl 'Ii 1'6aJ 1 ;i1 nl ;ii 't (ti) 51'1actl

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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0 CV (Y (rt' )o y ~ !) CV CV CV CV OV CV OV 0.-

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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

f.i~<ffi) ~ ~.

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Oliitil

nashik1 nuhmddhsnsk@gmail.com ~ ;., ..

/ . ),

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

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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 nrhmddhsnsk@gmail.com

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 nrhmddhsnsk@gmail.com

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.