1. Online Application

Online Applycation Form

TO
The CHIEF MEDICAL OFFICER OF HEALTH
BASIRHAT HEALTH DISTRICT

* Subject: Application for the Post of :

---Select Post--- Staff Nurse, NUHM VDB Technical Supervisor, NVBDCP Lab Technician (Blood Bank), WBSAPCS Laboratory Technician, NTEP District PPM Coordinator, NTEP District Manager (Public Health), QAP Peer Supporter, NVHCP Psychiatric Nurse/Community Nurse, NMHP Sanitary Attendant, NPHCE Hospital Attendant, NPHCE Counsellor, Anwesha Clinic Executive Assistant, School Health (RBSK&RKSK) Medical Officer AFHC under RKSK Programme Full Time Medical Officer, NUHM Lab Technician- District NCD Clinic, NPCDCS Senior Treatment Supervisor (STS), NTEP Lab Technician, NUHM

   * Memo No :

* Name:

* Father's/Husband's Name :

* Sex :

Male Female Others

* DOB:

* Caste :

UR SC ST OBC-A OBC-B

* Nationality:

* Mobile No :

* Email Id:

Permanent Address :

Same Mailing Address

Mailing Address :       

Educational Qualification :

EXAMINATION	Board/University/Degree	Total Marks (Excluding Optional)	Marks Obtained (Excluding Optional)	% of Marks
* Madhyamik (10th)
* HS (10+2)
Graduation
Post Graduaation
Diploma
Computer Course

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Experience :

sl	Organization	Govt/Private/NGOs	Period	Total Experience
1		Govt Private NGOs	To
2		Govt Private NGOs	To
3		Govt Private NGOs	To

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* Passport Size Image Upload:
**Note:Passport Size Image width 120 pixel x height 160 pixel; size not more then 600Kb

* Signature Upload:
**Note:Signature jpeg/jpg file format; width 160 pixel x height 60 pixel; size not more then 500Kb)

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* Uplaod all of relevant documents in one file (only pdf) (Academic, Experience, proof of age, cast, address etc.) :
**Note:Suport only pdf file ; size not more then 4.5 mb

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* Application Payment Fee's Amount(In Rs.) :

100 50

* Fee's Payment Transaction Deails:

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Submit