GOVERNMENT OF WEST BENGALHEALTH & FAMILY WELFARE DEPARTMENT

NATIONAL HEALTH MISSION (NHM)GN -29, 1ST FLOOR, GRANTHAGAR BHAWAN,SWASTHYA BHAWAN PREMISES, SECTOR-V

SALT LAKE, BIDHANNAGAR, KOLKATA - 700 091.

~ 033 - 2353 - 0432, Jill 033 - 2357 - 7930,Email ID: spmu.nuhm@gmail.com; website: www.wbhealth.gov.in

No. HFW/NUHM-232/2016/64Cf Dated: )_~.?2017

From : Commissioner, Health & Family Welfare &Addl. Mission Director, NHMGovernment of West Bengal

~To CMOH, Asansol HD I Basirhat Health District I Birbhum I Burdwan I Cooch-Behar I Dakshin

Dinajpur I Darjeeling (SMP)I Diamond Harbour HD /Hooghlv I Howrah I Jalpaiguri IJhargram HD IMalda I Murshidabad I Nadia I North 24 Parganas /Nandigram HDI PaschimMedinipur I Purba Medinipur I Rampurhat HD I South 24 Parganas I Uttar Dinajpur

Sub: Provisional Admission of Trainees for ANM Courseunder NUHM for UPHCin different ULBs

Ref: Notification No. HFW/NUHM-232/2016/3826 dated 9.12.2016

With reference to above, an approved list containing ULBwise selected candidates for ANM trainingunder NUHM received from your end is enclosed. The namesof the NursingTraining Institutions (residential orNon-residential) where they will undergo such training have also been indicated ULBwise in the enclosedstatement (Annexure I).

2. You are requested to send the photocopies of all the concerned applications along with all relevantdocuments of selected candidates to the Training Institutions before commencement of the said training. Youare also requested to send intimation to the selected candidates to join the allotted Nursing TrainingInstitutions within the period from 1.6.2017 to 7.6.2017 (excluding holidays). The class of ANM trainingcourse for 24 months duration will be started from 12.6.2017 in all the institutes.

A draft copy of the intimation letter is enclosed.

3. Failure to join the training course in time, or leaving the course midway for any reasons whatsoever,will result in the candidature being cancelled.

4. While sending the letter of admission to training course from the office of the CMOH, it should beclearly indicated that the admission is provisional and is subject to verification of original documents producedby the candidate in support of her age, residence and qualification.

After admission, if any candidate is found ineligible by any competent authority her candidature forundergoing training will liable to be cancelled and she will be terminated from the training course forthwith.Shewill also be liable to refund the stipend money paid to her.

-2-

5. The above selection for admission is provisional and subject to the decision or direction in differentcaseswhich may subsequently be received from Hon'ble Courts and competent authority.

6. Admission is also subject to medical fitness of the candidates for which they have to submit MedicalCertificate from a registered Medical Practitioner having at least a MBBSdegree in the prescribed format (copyenclosed). This Medical Certificate is to be kept in the Training Institutions.

7. The selected candidates are entitled to receive an amount of Rs.1000/- (RupeesOne thousand only)per month asstipend, fund for which will be sent to the respective training Institutions.

8. Accommodation will be provided to the trainees where the course is residential. NTSsthose arecompletely residential, the trainees will have to avail themselves of the accommodation.

9. The residential trainees will be provided free accommodation in the hostel. But they will have to makemessingarrangements at their own cost.

List of articles usually required to be brought by each trainee is enclosed.

Enclo -

1. Annexure 12. Specimen copy of Medical Certificate.3. Specimen copy of Model letter of the CMOHto the trainees.4. Specimen copy of Model letter to the NursingTraining Institution.5. List of articles to be brought by the trainees

commisS~'W) &AddI. Mission Director, NHM

No. HFW/NUHM-232/2016/6tt'l/I(lI.)Copy forwarded for information and necessary action to:

l. Director of Health Services, West Bengal.2. State Family Welfare Officer, West Bengal, Swasthya Bhawan.3. It. DHS (Nursing), West Bengal.4. Registrar, West Bengal Nursing Council, 8, Lyons Range, Kolkata - 700 001.5. Commissioner, (Howrahl Durgapurl Asansoll Chandannagarl Siliguril Bidhannagar)

6. Executive Officer, (Baduria, Basirhat, Bolpur, Suri, Burdwan, Kalna, Katwa, Coochbehar,Balurghat, Diamond Harbour, Arambag, Baidyabati, Bansberia, Bhadreswar, Champdany,Dankuni, Hooghly Chinsurah, Konnagar, Rishra, Serampore, Uttarpara Kotrang, Uluberia,Jalpaiguri, Jhargram, English Bazar, Old Maida, Jiaganj- Azimganj, Berhampur, Dhulian, Jangipur,Kandi, Chakdah, Gayeshpur, Haringhata, Kalyani, Krishnanagar, Nabadwip, Ranaghat, Santipur,Ashoknagar Kalyangarh, Bangaon, Baranagar, Barasat, Barrackpore, Bhatpara, Dumdum, Garulia,Habra, Halisahar, Kamarhati, Kanchrapara, Khardah, Madhyamgram, Naihati, New Barrackpore,North Barrackpore, North Dumdum, Panihati, South Dumdum, Titagarh, Ghatal, Kharagpur,

Dated:'(,(·5.2017

- 3 -

Medinipur, Contai, Haldia, Panskura, Rampurhat, Baruipur, Budge Budge, Maheshtala, RajpurSonarpur, IsIampur, Kaliaganj, Raiganj)

7. PNO, District Hospital, Coochbehar8. PNO, District Hospital, North 24 Pgns9. PNO, Chittaranjan Seva Sadan, 37, SPMukherjee Road, Kolkata - 700 02610. PNO, Howrah District Hospital11. Principal, Dr. H.C. Mukherjee Memorial Health School, Singur, Hooghly.12. Superintendent, Kharagpur SD Hospital, Kharagpur, Paschim Medinipur13. Superintendent, Bolpur SD Hospital, Bolpur, Birbhum14. Superintendent, Vidyasagar S.G. Hospital, South 24 Pgns15. Accounts Officer, ID & BG Hospital, Beliaghata, Kolkata16. Principal I Teacher-in-Charge, NTS attached to District Hospital, Coochbehar I District Hospital, North

24 Pgns IChittaranjan Seva Sadanl Howrah District Hospital /Bolpur SD Hospital/ Vidyasagar S.G.Hospital, South 24 Pgns I Kharagpur SD Hospitall ID & BG Hospital, Beliaghata, Kolkata

[He/She is requested to admit the trainees after verification of their original documents as well as medicalcertificate in the prescribed format by a Medical Practitioner having at least MBBS degree. He I She isrequested to send us the list of the candidates as soon admission is completed.]

A copy of the selection list as well as specimen copy of M.C. is enclosed for ready reference for 7 to 16only.

commis~ner (H&FW) &Addl. Mission Director, NHM

Format for Submission of Panel for engagement of ANM under NUHM

Name of the District: Burdwan HD

Name of the ULB:Kalna Municipality

No. of required no. of trainee: 2

Details of (10+2) Examination

51 Name of the Gurdian's Address with PhoneDate of Birth Marks obtained in

No Candidate Name NumberCaste Board I Year of Total %of Remarks

final Examinition RankInstitute Passing Marks

(best 5 subjects)Marks

CHOTOMITRAPARA,K

SIMA HALDER MANISHAlNA,WARD NO- Residentialcertificate

1(BISWAS)

13,BURDWAN,PIN- 01-01-1981 SC WBCHSE 2001 1000 451 45.10% 1 byViceChairman&BISWAS EO713409,MOB-

8436519520

2RINKUHALDER UTIAM YOGIPARA,KAlNA,

04-04-1986 WBCHSEResidentialcertificate

SC 2006 1000 409 40.90% 2(DEBNATH) DEBNATH BURDWAN byViceChairman

" I

fI,SI'"'~~M~ ~"

~,1----

SignatureM~on'ble ChairPerson

SI'"'~IIbR'r~~'~+--

Signatureof the DPHNO Sign~Ofthe Dy.CMOH-I Signatureof the CMOH of the RecruitmentCommitteeof

District~~~.teJS~~ 'iJ~e (Dev.)with Seal& Date KalnaMunicipalit)' , <iM,.QJI.-1 with Seal& Date the Districtwith Seal& Date'MOO'", , "1:::11 tl8_n.ga,_ l~

___raw..Dlst. Public Health Nursing Officer

Burdwan . CMOH& SecretaryDH&FWS,Burdwan

"

Format for Submission of Panel for engagement of ANM under NUHM

Name of the District: Burdwan HD

Name of the ULB: Katwa Municipality

No. of required no. of trainee: 3Details of (10+2) Examination

Sl Name of the Gurdian's Address with PhoneDate of Birth Board /

Marks obtained in

No Candidate NumberCaste Year of Total %of Remarks

Name final Examinition RankInstitute Passing Marks

(best 5 subjects)Marks

GURUPADAGHOSHHAT,MADHITALA,K

CHSSEResidential

1 KABITA DASDUTIA

ATWA,BURDWAN,713130, 01-05-1989 GENERAL(DELHI)

2014 500 380 76.00% 1 certificate by

MOB-9732103969 Councillor

KATWANATIONALSANCHITA LAHA BIKASH PARA,WARDNO-

WBCHSE 671 2 Residential2 04-05-1989 GENERAL 2006 1000 67.10%

(MONDAL) LAHA 14,KATWA,BURDWAN,713 certificate by SDO

130 Ph. No. - 9749135999

ANUPAMMADHABITALA,KATWA,W Residential

3 BHASWATI SAHA ARSNO-7,BURDWAN,PIN- 23/02/1979 SC WBCHSE 1999 1000 359 35.90% 10 certificate byMUKHERJEE 713130,MOB-9874059555 Councillor

~ ~L---

s;go""w..,,'bI. C",;,Person.. Signatu~'L Signatur~rffi'ilierson

~)-~)ure of the DPHNO SirJ»w(f!~'B:'_fi-1 Signatureof the CMOH of the RecruitmentCommitteeof

DistrictM~ 1WIIt!!lt ~: • ft. AI",.; •• !«I_tWa'u;.:nil'"in"iih. '1. wID..c......I1)Gtite with Seal& Date the Districtwith Seal& Date• ,;." rvu.~ ...., IUILP' .... -J

CMOH & SecretaryDH&FWS, Burdwan

Burdwan

Name of the District: Burdwan HDName of the ULB:Burdwan MunicipalityNo of required no of trainee' 10

Format for Submissionof Panelfor engagement of ANM under NUHM

, -- Details of (10+2) Exami,nationSI Name of the Gurdian's Address with Phone

Date of Birth Caste Board / Year ofMarks obtained in %of Remarks

No candidate Name NumberTotal

final Examinition RankInstitute Passing Marks

(best 5 subiects)Marks

MOUSUMI ANUPAM TEJGANJ,MOHANBAG,SRIPALtY,BURDResidential

1BANERJEE MUKHERJEE WAN,713103,MOB-7872654350 18/09/1990 GENERAL WBCHSE 2008 500 377 75.40% 1 certificate by

rnllnrillnr

PALLABI ROY SANDIP SHANTABARATASAIN,123 EAST Residential

2 (CHATTOPADH CHATTOPADHYANATUN PALLY(JORAMANDIR),P.O- 03-04-1991 GENERAL WBCHSE 2008 500 358 71.60% 2 certificate byNATUNPALLY,BURDWAN-<l1,MOB-

YAY) Y) 9547172914Councillor

SAHIN SKSHAHHEKAMAL SAYAR Residential

3SULTANA

PASCHIMPARA,RAJBAn,BURDWAN,71 04-10-1989 GENERAL WBCHSE 2007 500 357 71.40% 3 certificate by ViceZAMAN 3104,MOB-833780996O Chairman

SAMIR52HK.CHATTERJEE Residential

4 RIMA MANDAL LANE,RAJBATI,BURDWAN,713104,MO 02-09-1990 OBC-B WBCHSE 2007 500 351 70.20% 4 certificate byCHANDRA B-9153367390 Councillor

RUMASAINBIOHANPALLY Residentia I

5 PAPU MALLICK GHOSHPARA(PVRBAMATH),SRIPALLY, 04-12-1986 GENERAL WBCH5E 2003 1000 679 67.90% 5 certificate byMALLICK BUROWAN-<l3,MOB-9547511029 Councillor

5NO ICHLABAO,OLlCHANOITALA,P.O- Residential6 PREETI KUMAR NAREN PAUL SRIPALLY,OIST-BURDWAN-03,MOB- 14/07/1989 OBC-B WBCH5E 2009 500 339 67.80% 6 certificate by SDO

96477773777

LATIKA SK Residential

7 KHAGRAGARH,RAJBATI,BUROWAN,W 06-09-1988 OBC-A WBCH5E 2006 1000 649 64.90% 7 certificate byKHATUN MOHAMMAD ARD-01 MOB-9681201683

rc ..... ' I: CouncHlor

GAYATRIMOHANBAG Residential

8 TAPAS KONRA EAST,SRIPALLY,BURDWAN,713103,MO 28/04/1990 5T WBCH5E 2007 500 289 57.80% 24 certificate byMUNDA B-9093581213 <:nlJncilior

3 NO SAKHARIPUKUR(NEAR Residential

9 TAPATI MITRA SAl KAT MITRA OAROGAMAAT)SRIPALLY,BURDWAN- 18/12/1989 SC WBCHSE 2007 500 284 56.80% 25 certificate by03,MOB -9933100942 Councillor

TEJGANJ(AOARSHAPALLY),NATUNGANResidential

PAPIYA DINESH KUMAR certificate by10 J,BURDWAN,713102,MOB- 26/02/1986 SC WBCHSE 2004 1000 552 55.20% 29

PAKRAY PAKRAY 8697560201 (\Councillor &- ",hh:"lhin::>ti 7P

t;) h<;JeSI/¥- ~~

Signature~~ Hon'ble Chair Person

Sign~~~fthe~f)

~.~i Signature of the DPHNO . Signature. of t~~_ersonSig~~tle~~~l1~r-1

Signature 0 he CMOH of the Recruitment Committee of

Dist ...... _0 ist. PubIit; tIooJlb (Weir-a(If{irtl Burd~afl Ijty with Seal & Date the District with Seal & Date.......... IInIn, WISt Iii' Burdw BURDW~N~l UIUQWan ~MUH iSl. :-'''''T""t" ...,an

51.No. District

Annexure I

ULBwise Number of ANM & Training Institute

ULB

Katwa

requiredNumber selectedof trainee for 1st numberof

phase trainee

Residential!Non­residentialTraining Institute

I

Medical Certificate in case of appointment of candidates underWest Bengal state Health & Family Welfare Somiti

Name ot Ihe candidate in tull (in block letters)

Height (without shoe)

Weiglll

Cm.

Kg.

"1 hereby certltv that I hove examined Sri/Smt. " , a

.candidate for employment in tile Wesl Bengal State Health & Family Welfare Samiti. and can'l

discover thaI Sri/Smt , ,.., " ,......... has any disease.

(communicable or otherwise) constitutional weakness or bodily infirmity,

except. " .." " ,,"

I do nol consider this a disqualification for employment in the office of Slate Somiti.

Sri/Srnt 's age is.according to hisown statement. Years,

and by.appearance about. " ""." " yeors".

a. General Development Good/Fair/ Average/Poor

b Vision Righi eye: Leff eye:

i. Uncorrected/Naked eye

ii. Correcled

iii. Nature and degree

c. Teeth: d. Hearing e. Blood pressure:

t. Lung: g. Heart h. Liver

i. Spleen

j. Hernia (present or absent)

k. Hydroeceles (present or absenf)

I. • Urine i. Specific Gravity Ii. Albumin iii. Sugar

rn. Identification marks

n. TheCandidate is

P.~eIoil

Doted:

Signature of Candidate

Attested

. 1

i. Fit

ii. Unfit on account of

iii. Temporarily unfit on account of

Signature of the Medical Pllli:<titioner

Name

Degree

Regn. No.(Seal)

Government of West BengalOffice of the CMOH .

District .No. Date:

ToSmt ..Address .

MunicipalitylMunicipal Corporation .District ..

Sub: Provisional admission for training for ANM Course under NUHM

With reference to above subject, I am to inform you that you are selected for 2 years

ANM training course under NUHM. You are therefore requested to report to the Principal /

Sister Tutor In-Charge or the Officer-in-Charge of the

Nursing Training School positively within

........................ (excluding holidays) .

Failure to join in the training course in time, or leaving the course midway for any

reasons whatsoever, will result in the candidature being cancelled.

At the time of admission you should bring Medical Certificate in the enclosed format

from a registered Medical Practitioner having at least MBBS degree. You should also bring

original certificates in support of the age, educational qualifications, caste certificate and

residential status, which will be returned to you after verification.

Venue of training centre will not be changed under any circumstance.

All trainees are entitled to receive a sum of Rs. 1000/- (Rupees One thousand only) per

month as stipend. Accommodation will be provided to the trainees where the course is

residential. NTS, those are completely residential, the trainees will have to avail themselves of

the accommodation compulsorily. The residential trainees will be provided free accommodation

in the hostel. But they will have to make messing arrangements at their own cost.

List of articles usually required for the residential trainee, which will have to bring by

each trainee is enclosed.

After admission, if you are found ineligible by any competent authority, your candidature

for undergoing training will be liable to be cancelled and you will be terminated from the

training course forthwith. In that case, you will also be liable to refund the stipend money paid

to you.

Selection / admission is provisional subject to decision of any court of law in future in the

matter and verification of original documents as to age, residence, caste certificate and

qualification as well as medical fitness. It is reiterated that selection / admission will be

summarily rejected / cancelled if any of the documents produced by you is found to be notgenuine.

CMOH, District .

Government of West BengalOffice of the CMOH .

District .

No. Date:

ToThe {In-charge of NTS).......................................... {Name of the Nursing Training Institution)

Sub: Admission of trainees for ANMCourse under NUHMfor theUPHC of the ULB

Sir / Madam,

With reference to the above subject I am sending the photocopies of

the applications alongwith all relevant papers of the selected candidates of

Municipality/ Municipal Corporation for taking further

necessary action from your end in terms of letter no .

dated from the Department of Health & Family Welfare, West

Bengal.

Yours faithfully,

CMOH, District

A.N.M. TRAINING UNDER NUHM

LIST OF ARTICLES REQUIRED TO BE BROUGHT BY EACH TRAINEE

FOR RESIDENTIAL STUDENTS

SL No. Materials Quantity1 TRUNK WITH LOCK 1 PC2 MATIRESS SINGLE 1 PC3 PILLOW 1 PC4 MOSQUITO NET 1 PC5 BED SHEET 1 PC6 BED COVER 1 PC

7 BLANKET 1 PC8 MUG 1 PC9 TIFFIN CARRIER/BOX 1 PC10 RICE PLATE 1 PC11 GLASS 1 PC12 BATI 2 PC13 SPOON 2 PC14 BLACK HAIRNET 1 PC15 PERSONAL TOWEL (TOOTHBRUSH,PASTE) 1 PC16 EXTRA LOCK & KEY(FOR ROOM) 1 PC17 B.P. APPARATUS TO BE PURCHASED LATER

ON18 STETHOSCOPE DO19 MONEY (AT LEAST RS.5000/) FOR UNIFORM,BOOKS,

B.P. APPARATUS,STETHOSCOPE etc. - TOKEPT WITH THE STUDENT

20 TORCH 1 PC21 UMBRELLA 1 PC22 PERSONAL DRESSES AS PER NEED23 PENCIL BOX ERASER,PENCIL, PEN,

SCISSOR, RED BLUE PEN24 NOTE BOOKS 8- (No.4-8)25 White paper 4 DISTA

------------------------------------- . --

A.N.M. TRAINING UNDER NUHM

LIST OF ARTICLES REQUIRED TO BE BROUGHT BY EACH TRAINEE

FOR NON-RESIDENTIAL STUDENTS

SL No. Materials Quantity1 BLACK HAIRNET 1 PC2 B.P. APPARATUS TO BE PURCHASED LATER ON3 STETHOSCOPE DO4 MONEY (AT LEAST RS.5000/) FOR UNIFORM,BOOKS,B.P.

APPARATUS, STETHOSCOPE,etc - TO KEPT WITH THE

STUDENT5 TORCH 1 PC6 UMBRELLA 1 PC7 PENCIL BOX ERASER,PENCIL, PEN, SCISSOR,

RED BLUE PEN8 NOTE BOOKS 8- (No.4-8)9 White paper 4DISTA