Pw w,

DgU v PlA Pt U , DAzg v, AUg-560 009.

DgU v PlA Pt ESAi S Eg l CmAqAm U q-2
U
'r' 2323 S zU

U Pw iq U.

CsyUU ZU


CZ AS: JDg/57/2011-12, AP:31.05.2012
CfU
D- P
PAi AP:30.06.2012(Ae 05:00 UAmAi)gg U

AP Cf w PAi AP:04.07.2012
Pgz v AS:DPP/342/ZJJA/2009, :01.12.2011 v Pgz Pgq

Aii AS:DPP/06/ZJJA/2012, AP:29/03/2012g U Pgz CAw
Aii AS:DPP/06/ZJJA/2012, AP:23.04.2012g ejU Az PlP
DgU v PlA Pt U (U
r zU
Pw) () AiU
2012g g.9600-200-12000-250-13000-300-14200-350-14550g v tAi Pj
Dz AS:DPP/342/ZJJA/2009, AP:07.05.2012g Cag f Dv U
,
vP Dv U
, zAi DgU PAzU
v x
P DgU PAzU

S
Eg Ml 2323 l CmAqAm Uq-II U
r S zU

U C Cs yUAz
m www.karhfw.gov.in ON-LINE P CfU
Dz.
1. z
, v t, zU
AS, Urg zv v Aiw g F
PP A qAwz.
P

AS
1

zA i z
v t
v Ml zU

2

Urg P
zv
3

l CmAqAm Uq-II, J.J.J./

10 vgUw

Ur 2323 S
jPA i
zU
.
vUqAiiVg P
v t g.9600-20012000-250-13000-300-14200350-14550

Aiw
4

P :-18 U

Uj
. :-35 U,
U:- II(J), II(),III(J),
III():-38 U,
.e, .A & U- I:40 U,

DAi zs:- CsyU Urg zvAi Ug CAPU

v w
Dzsgz DAi iqUz.
Page | 1

U
r zU
-2323(VPgt
)

i Ut

if
P

Pq
izs

Aid
gvg

CAUPg

Ml

.Cv

233

348

290

116

58

58

58

1161

.ew

70

105

88

34

17

17

18

349

.A

14

21

18

70

U
-1

19

28

24

93

U
-II(J)

70

105

87

34

17

17

18

348

U
-II()

19

28

24

93

U
-III(J)

19

28

24

93

U
-III()

23

35

30

11

116

467

698

585

229

113

112

119

2323

Ml

nt
: Png zU
AS v VPgt
CAi AzsU wAi tAiP
Mngvz.
Online 



.
 &
&
1.
 
(Online)
&
.
2. (Online)
 35mmx
mmx45mm
mmx mm
 @  

Scan JPG Format save . Save

(Size) 100kb
kb .
3. (Online)
SUBMIT FRESH APPLICATION  
.    

Scan
Scan  Upload
.
4. 
 @ Preview
.
Edit .
Preview 
.
5. 


Preview


 Preview

.
6. 
(SUBMIT)  Application No Password 
 .
 

.
Page | 2

7.   Generate
Bank Challan ,  Password
(Application ID) 

  ,
.
8.
 Print Applicaion
.
(Application ID)  
9. (Application
  . 
.
10.


 &  Online

.
11. CsyU ESAi m www.karhfw.gov.in ON-LINE

APPLICATION C QP ir Czg
vjVg Cf AiAi Cg
gU
sw
iqP. F Cf Ai sw
iq EzgAU
qU ZU
NPAq eUg
PvAz CfAi sw
iq P. CsyU
ON-LINE P CfU Urz PAi APz
U sw
iqvPz. PAi
APz
g U
PAiz gg ei DV CAve AP PrvU
Aq Uz Eg
As

gzjAz AavV CfU
sw
ir
wvP z.
CfU D- (ON-LINE) (JP
P iU) SAvg iv v P z
,
CfU RzV Cx CAZ P v PV
CPg.
C) CsyU Aiiz v iwAi qz Cf sw
iq ON-LINE
rg ZU
A i sw iqvP z
.
D) v iwU r Cf z
CAvg gz ES PA i P
P PU
Uz.
2. CfAi wU AAz CAPtz GAiVz zU
Cx F PPA qAv
CxPP:SC
ST
C-I
CII(a)
C-II(b)
C-III(a)
C-III(b)
GM
Ex-MP
Rural
KMS
PH
PDP

-Scheduled Caste
-Scheduled Tribe
Cat-I
Cat-II(a)
Cat-II(b)
Cat-III(a)
Cat-III(B)
General Merit
-Ex-Military Person
-Rural Reservation
-Kannada Medium
-Physically Handicapped
Project Displaced Person

3. Png zUU Urg zv, Aiw, w Ev zRU

ON-LINE SAvg CfU Pj Urg PAi APP z
AAzsl PgAz qz CsyU Ag P.
4. :- Urz v w Pz zs:Page | 3

i Cv, U 2(J), 2(), 3(J), 3() U jz CsyUU

j ew, j AUq, U
-1 P jz CsyUU

g. 300/g. 100/-

5. ON-LINE SAvg Cf z Avg F PP A q wz zsz

Aiizzg
MAz jwAi Cf
wzVz.

gdzg Pg AQ J SU fg nA i zgt
ASAiAU m Cs yU iwUV qVz.
zs-1
Z qq irPAq Avg Uv PlP gdz
Pg APU
Aiiz SU
qq irPArg
Zr Cf wvPz.

Cx
zs-2
Pg AQ SU
Ez
z CsyU Aiizzg
AQAz
Corporation Bank Account, Health and Family Welfare Services, Payable
at Bangalore. Eg j rr qz
Czg AsUz
CsyAi g Cf
AS v zgt AS qq irPAq Z rrU
gU
F PP A q AQ P PjAig Cx CAZ SAvg
PvPz(Uv PAi APz MU vvP z
).
Corporation Bank
CAPS-BANGALORE
#21/1, Jelitta Tower, 2nd Floor,
Mission Road, Bangalore-560027
Phone Nos.080-22111222, 223, 224, 225

Cx
zs-3
U Pg AQ SU

Ez
U

CsyU
NEFT(National Electronic Fund Transfer) PAi Eg Aiizzg
AQ, zj AP q NEFTU AAz Z SAvg F PPA qAv
iwAi Cf wz Avg PAlg Ai(Counter
Foil) CsyAi ElPArgvPz(CfAi vAz Avg
q

Z w
Ai CPg.).
1. Name of the Bank: - Corporation Bank
2. Branch :- FCS-Bangalore.
3. IFSC Code- CORP0000633
4. Account No.R4942 ----------- (Application No.)
Cf w U a iwU C Pv Ez
Pg AQ
CPjU F PPA q zgt ASAi AQ iw qA izVz.
080-22111222, 080-22871120, 9845077388, 9945501577,

Page | 4

6. CsyU ON-LINE P Cf sw iq z ZU PqAiV

N wzPv P z.
6.1 CsyU Cf
Urz PAi APzgU A iqz AavV
CfU v Pz. M wz Avg Cz Aiiz AzszA i
AgVU. Cx Cz Evg Aiiz jP Cx PwUU
AP
U.
Cf
gA s AP:01.06.2012
Cf
PAi AP:30.06.2012 (Ae 5:00 UAmAigU
).
AP
w PAi AP:04.07.2012
Z: On-line P CfAi sw
iq Azs z vAwP vAzg Cx
Jzgz Ait (Help line) 22371801, 22371802, 22372103, 22372045,
22340126, 22873151(Extn. No.347) v JJJ U Kgm zgtAi
P (Gav Pg. 080-1056P) U 10:00 UAmAz Ae 5:00 UAmAigU AQ CUv
iw qz Cf z. (sg v Evg Pj ge U
gv r)
Cv gv U
:C) sgwAi UjPVgvP z
.
D) M fAv wVAv Z A wAig Ag g Csy v
FUU E Aqw Eg QAi zAiiVg CsyAi PgAz
wAi qA iz PwU CgU.
E) CsyAi iPV v zPV DgUAvgVgP v Cg
PwAi PvU zP uU
DvAP Al iq As Eg Aiiz zP
vAz PgVgP.
F) zPV CgVzgA z zQAi AqAi rz gAi
CgAzV wgj t ZA i wAi PjPArz v Pgz
ZA i Aiiz zsz
F AiU P vVg. CAUPg Aiiz
zU Urz Pv v djAi zPV xg JAz
Pw w j zrPjz Avg
CsyAi DAiA i jUt
Uz.
7. Pt
P zv: CfU sw
iq Urz PAi APzA z CaAi
Caz zA i Az ag zvAi Cs yU PqAiV
AgP. zU Urg zvAi CsyU On-line CfAi
V P.
8. Aiw:- CsyU CfU
Urz PAi APzA z Cs yU
Uv P AiwAi Ag P U Uv Uj AiwAi
jggz.
F PV
Azs U
PwAi Uj AiwAi PU
wgg nU
a
Uz.
Page | 5

(C) CsyAi PlP gd Pgz

Cx
Ai Pgz Cx gd CAi
Cx PAz CAiz P A iiz Cx gd CAiz Dx PAz
CAiz P UAq PlP gd Pgz Cx AiAvtzg
Uz z Ag Cx Az Az Uj AiwAi C/C J
U CU D zA i wg g
Cx Az zg
C U
Cx 10 U C Czg Aiiz PrAi C U.
(D) CsyAi if PVz C PAz zz
J g
C UU g U jzg J UUz C U.
gu
: - (1) if P JAzg PAz zU

z Aiv sz, Pz v Ai
zz Aiiz tAi (Aizs Cx Aizs
z
) z Q, Dzg rs Pjn
Pg, dg
j EAfAijAU s
, P AiP v g lj
zz z Q qAiiU. v
(2) PAz zU
U Pl
Cx v V zP Pv
Az QU
PlAzg (Azs g Aqw Cx UAq v P
v
P
) if P wU CgVgvg. Dzg CAvgUU Aiw rPAi
qU.
C) CAv Az w Az Avg w v qA iwg
Cx
D) zQAi PgtUAz lj Az qUqA iiz Cx QAi rvP
jz jwUAz v zQAi Cx Cxz AZt qz CAv Az
qUqA iiz Q.
Cx
E) A v PjP gvr A Prvz juAz CAv Az qUq
Az Q.
Cx
F) v A v PjP gU Cx zqv Cx Cxz PgtAzV
vUzQg Cx PvAz e irz QU
gvr, CA i
gz vgAi qUq Az Q v UZ n qA iwg Q v AwAi
Ai F PU j z Uz AAig :1) gAvg z w Az AZtzgg.
2) lj AzV GAmz zP Cxv A qUqA iiz Q.
3) UAn evg.
gu
:- PAz zz Aig QU
Az w Az Avg if
Pg Uzr g QU MAz tU MAz P g
GzUP Cf QP
U CjU if PjU zgAi J sU
Az Cw qVz. Dzg
vf Cw qgU gd UjP
Cx zU P AzAw.
(E)CsyAi CAUPVzg 10 U
Page | 6

(H) CsyAi PlP gdzg sgv Pgz dUt

w AA i FU
zA i Azg Cx Az Az Pz
Uj AiwAi C/D
J U CU D zA i wg g
Cx Az zg
C
U Cx 5 U C Czg
Aiiz PrAi C U
(I) CsyAi zsA iiVz
10 U . (
i t v v gj Az
qz P.
(I) CsyAi fv PVz Pz 10 U .
G PArP 7.(I) g gU AiwAi rPAi Pg CsyAi fv
PVz, zj CAi Cx 1957g PlP fv PP zw
(gA iiw) Dzz
gU fv AzAi iq uAz qUqA iiVzA z
it v f
ifmjAz qz CfAiAU Uw
P.
ew / w
it vU
:w PgAi Cs yU F PU
g U
A i w
it vU
qlPArgvP z
: C) j ew v j AUqP jz Cs yU:- `r'(CAzs- 1)
D) U-1 P jz CsyU:- `E'(CAzs- 2)
E) U-2J, 2, 3J v 3 wU jz CsyU:-
`Js'(CAzs- 3)
Cf
Urz PAi APzA z ZAig w it
v AAv v ggj Az q
lP
ArgvP z. CAzg Azz U U U2J, U-2, U-3J v
U
-3 Uz w
i t vU

qz
APAz CfU
Urz PAi APzgU Lz U
CAiVgP, zRw j Aiz vz
dgrvP z
, vz
CAv CsyU wAi gz
r
Cg Csyv Cgz iv i
CvAirAi jUt
Uz. F
i t vU
U
F ZU

vjVz. w it v ej irz AP vz CfAi AAzsl

CAPtz vPz U Cz
i t v
zRw j Aiz
dgrvPz. F U
gv r Evg Aiiz U


q

w it vU
wgj Uz.
9. Ut Csy
Pj Dz AS DE 96
2005 AP 10.08.2005 gA i Ut wAi
Pg CsyU v ZAig AiU jv 1 jAz 10 vgU
w
AigU
Ut
wU Mq
zU
AU ir GwtgVgg F wAi
qA i Cg. Ut CsyUUAz jz zU
Pi iq CsyU
-2 AAzsl
Pv Pu
PjAig gdAU U i CvAi
Ut w Ai CsyU gP jg U -1 g it
v PqAiV AAv v ggj Az qlPArgvPz. CAvAi Ut
w Pg j ew, j AUq, U
-1, U-2J, 2, 3J, 3 wU
Page | 7

jz CsyU PqAiV Ut wAi

it v -2g AAzsl
Pv Pu
PjAig gd ir qlPArgvP z
. zRw jU
vz dgrvPz, vz CAv CsyU wAi gzr
Uz. (Evg
U

q
w
i t vU
wgj Uz U CAvg
Ut wU CgUvg. F
i t vU
U
F ZUU
CA
Vz) (CAzs- 4).
dg
jm CsyU g P jA z zrPj Ut wAi
Pg Pz it v -1
10. Pq izs Csy
Pj CZ AS DE 71
2001 AP 24-10-2002 gA i P q izsz
CsyUUAz jz zU

P iq CsyU 1 vgUw
Az 10
vgUw
AigU Pq izsz AU irg U AAzsl
Ai SzsAig
U jAU it v
qlPArgvPz. zRw j
Aiz vz dgrvPz, vz CAv Cs yU wAi
gzr
Uz. (F it vz
Ai F ZUU CA
Vz)
(CAzs- 5).
11. CAUP Csy
Pgz CZ AS: rJDg 50 JDgDg 2000 AP 03-09-2005 g gd
U
- `J' v `' UA zU

U Pq 3 g (Pgz CZ
AS rJDg 21 JDgDg 2008 AP 03-08-2009g CaAir q
iqVg ESU
) v `' UA zUU Pq 5 g (Pgz
CZ AS rJDg 52 JDgDg 99 AP 29-11-2002g CaAir
rVg ESU
) zU

CAUPjU w P z, EzgA i Pq 40
QAv Pr EzA v CAUPvAi Cs yU iv F wAi Pg Cg.
Pgz CPv e AS DE 115
2005 AP 19-11-2005g Urg
Ai CAUPv U f lz zQAi AqAz
i t v


q
lPArgvP z. zRw jU vz
dgrvP z
, vz CAv
CsyU wAi gzr
Uz. Evg Aiiz Ai CAUPvAi U
qA iVg it vU
/ Ugw anAi w
U jUt
g. F
it vz Ai F ZU

U CA
Vz. w it v ej
irz AP vz CfAi AAzs
l CAPtz vPz (CAzs- 6).

Page | 8

12. Aid gv Csy

Pj Dz rJDg 23 J.Dg.Dg. 99 :23-11-00gAv AidUAz gvgz
PlAz CsyU Pj v AS: DE 44 AP 27-07-2001 g
Urz Ai it v
AAz v g gj Az DAi
r
PArg AP

V g
i t v
v Cq
lg(Award
Letter) Cf
Urz PAi APzU
qlPArgvPz (CAzs- 7)
13. AU
it vz U
PlP gdz v UU Pr EzA v CAzg MAz vgUw
Az 10
vgUw
AigU AU iqg Aiiz Cs yAi F AiU CrAi DAiU
CgU. CsyU 10 PlP gdz AU irg U AsA zl

U
SzsAijAz i t vU

qz
CfU
UrVg
PAi APzU qlPArgvP z
.
14. Pj Aig Pgj U
CsyAi PlP gd Pgz
Cx Ai Pgz Cx gd CAi
Cx PAz CAiz P A iiz Cx gd CAiz Dx PAz
CAiz P UAq PlP gd Pgz Cx AiAvtzg
Uz z Ag Pgg it v AAzs
l
ES Rj Az
qlPArgvPz. (CAzs- 8).
15. ZU
:CsyAi Ewa m CvA i sav MAz Ai l Czg
PU P Ai Z/ iPg ir Ez ir CfU UPLOAD
iqP. F PPA q it vU

Uv Ai ON-LINE P Cf sw

iq Urz PAi APz
U AAzs
l
P jUAz q
lPArgvPz
U Pjg w
i t vU
v Evg
it vU

Cf sw

iq Urg PAi APz
U q
lPArgvP z U Cz w

it vz w
Ai zRw jU dgr P. Evg
U
Cx Cf sw
iq Urz PAi APz Avg qz Aiiz

it vU

jUt
U. vz

Eg wAi /Csyv

C UUz.
1) zU Urz (CfAi sw
irz Avg wvPz)w
gw(Z w).
2) d AP g J.J.J.. Cx Uu i t v/d
AP vj Aav zRAi Gz v sU v Pz
U CfU

Urg PAi APP Aiw jggz.

3) gPu
v (No Objection Certificate)(Pj Aig Cs yUU)
4) P Az qUqA iiz / Q Az UV
i t v / if P
CAvgVz, if Pg qUq Ag PgtU it v (if
Page | 9

5)
6)
7)
8)
9)

Pg AigU v
n
z

Cx SAiA DV UAiUArg it v)
(if P w Pjz
)
j ew, j AUq,
U
-1, U-2J, U-2, U-3J, v
U-3 w i t vU

v ZAig U
(w
Pjz)
Ut w it v -1 v 2g (w Pjz
)
Pq izsz AU irz
i t v (w Pjz)
CAUP w it v (Aiw rPUV w Pjz).
zsA iiVz v jAz g zAiiUg U
i t v (Aiw
rPUV).

ZU
:(1) ON-LINE P Cf U J iwU jAiiV sw
irg U
Ravr
PAq Avg Czg MAz w
Ai Download irPAq sz
V
ElPv Pz U zRw j Aiz dgrvPz.
(2) FUU Aig / z Cs yU CgU Pw PjUAz
Cf
Urz PAi APzU Cw v qlPArgvPz
U gU
CfAi vP z
.
(3) CfU sw
iq PAi AP wP ge V Wl
g D
APz igA i Pz CfU sw
iq PAi APUz.
(4) zA
i Pv v djAi PAiu: - DgU v PlA Pt
ESAig f Dv U
, zAi DgU PAzU
, vP Dv U
, v
xP DgU PAzU

g QP PAiU AiP iv P
(for
clinical support only) Pj Dz AS:DPP/342/ZJJA/2009,
AP:07.05.2012g Caz Ml 2323 l CmAqAm U q-II, Ur
fg S zUU v t g. 9600-200-12000-250-13000-300-14200350-14550g Pw A Pv Cs yU Dv U
QP
PAiU AiP CAzg Dv U

aQvU Mq
gVUU, jU Aiz,
aQv PorU GPg t
U Aj z, UAiiUU Aqe iqz,
gVU PorUU
Avjz, gu
vg jPA i zjU Ai iq
P U Dv U
CmAqAm U
r zA i P PAiU U
AAzsl zPjU/Dqv zPjU a Ur U AAz
PvU v djU vP z
U zv Dzsgz Az
zuU CPg.

Page | 10

16. zqv: - M CsyAi P

QAiiVgA z Cx Sm zd Cx
wz
z zdU gA z Cx v Cx P rgA z
Cx P iwAi gi agA z Cx Pw GzUUV q
U
zQAi jPA i / zRw j Aiz Cav iU
CjwgA z Cx Cj A iwgA z Cx Cg PwAi
AAzsz Aiiz Evg CP v Cav iU CAgA z, PAqAz
C/ C v : Q g u
U

U v PP Mq
zz; zA i
DAiAz Csyv gzr
Uz.

/z PAiz.
Pw w U
R DqvPjU
DgU v P.P.U .

Page | 11

CAzs- 1
(.e. / .A.P jz DsyUU iv)
- r
(Ai 3J(2) (3) r)
Cav ew v Cav qPl
U
U jz CsyUU q
it vU
.

it v
.gdz / PAzq
v z z * .fA i / sUz .U / lt
*
Aiiz / w . JAg U / Uz / w .Eg Cav ew /
Cav qPl
* JAz i iqVg ew / qPn
U
* jgvgA z
itPjVz.

Azs (Cav ewU) Dz, 1950

Azs ( Cav qPl

U ) Dz 1950
Azs (Cav ew) (PAzq
v z U ) Dz,1950.
Azs ( Cav qPl
U ) (PAzq
s v z U ) Dz, 1951
(Cav ew v Cav qPl
U n (iq) Dz 1956 , A gd, g
gZ
CAi CAi, 1960, Ae gd g gZ
CAi, 1966, iZ z
gd CAi 1970 v F z U (g gZ
CAi, 1971 g P
wz
r
AiizAv).

Azs (d v Pg) Cav ewU Dz 1956.

Cav ew v Cav qPl
U (wz
r
) CAi, 1976 g P
wz
r
AiizAv Azs ( CAqi v Pg U ) Cav qPl
Dz 1959.

Azs (zzg v Ug ) Cav ewU Dz, 1962.

Azs (ArZj) Cav ewU Dz, 1964.

Azs Cav qPl
U (Gvg z ) Cz1967.

1.

Azs (U , z v ) Cav ew / qPl

U Dz,1988.
Azs (UAq) Cav qPl
U Dz
/ w Pij * v / Cx C* /C*
PlAgd/PAzq
v z zf / sUz * ..U /
lt
z i (U).
:
v g

:
AP :

z

Pb jAi jAU
gd / PAzq
v z *

CAiUg zU

zAil lr / qz Q,
Z: - E GAiVz i U JA zAi e
wzs CAi, 1950
g 20 P g t
zg Cx Agv
.
sgv Pgz v AS : 12028/2/78 J n U AvAiz CgV, CAx
it
vU

q P
VgzPV, sgv Pgz (A v Dqv zsgu ES) v AS:
13/02/1974 EJ n) AP 5 DU 1975 g z PjAi, g
w
U AAzs
l

Dzz CZA i grz Aiz
it vP V Cf z QAi, v SAiA


Az P jzg gVgvP z, Cz jwAi, MAz vQ g P jAi
EAz vQU jz QU
U AAzs
l

it v

q P
P jAiiU.
Page | 12

CAzs- 2
(
U
- 1 P jz CsyUU iv)
- E
(Ai 3J (2) (3) r)
Azz U UU jz CsyUU q
it v
.U/lt
/Ug z
Aiiz ./w
Eg U / U / w / wAiiz / w .Eg Azz U U
(
U
) ewAi G ewU jgvgA z
itPjVz.

:
AP :

v gg
.vP
Pb jAi g.

Page | 13

CAzs- 3
(
U
-2J, 2, 3J, 3 U jz CsyUU iv)
- Js
(Ai 3J (2) (3) r)

U
- 1 g gvV , Azv U UU jz CsyUU q DzAi v ew
i t
v
.g Vg / w Eg U/U/w/wAiiz, /
w / Pij Eg v Dv / C vAz v/Pg / w / wAi,
Pj DzU AS : J qr 225 J 2000 AP : 30-03-2002 g rz
g z (Q Aig) Ai gA z :
CsyAiiU Cx Dv / DPAi vAz v/ Pg U / w/wAiiU, Pgz
Ai 1 ze Ai Cx 2 ze Ai CPjAiiVA z :
Cx
dP Ai Gzz vv
iz zA i AgA z
Cx
Sw AidPg PPU
, 2 ze Ai CPjAi AQA v ( v t g 6000-12000/gA P Av) Prz A
qA i Pg
VA z :
Cx
Dv / DPAi vAz v / Pg / w/ wAi DzAi Jgq P jgA z :
Cx
PlP s zsgu CAi 1961 g UrgAv Dv / DPAi vAz v / Pg / w
/ wAi igl vjUzg
Cx Dv / DPAi vAz v / P/w/wAi Cx Ejg
10 Aim VAv a
P s Cx 25 JPgU

VAv a
Am sAi AgA z

itPjVz. Pj Dz AS : J q r 225 J 2000 AP : 30/03/2002 g CAi

/ w / Pij Eg ..ewU jz GewAigVz, Pj
Dz AS : Jqr 225 J 2000 AP : 30-03-2002 g CAi Azz U U

U
..(2J, 2, 3J, 3) jgvg.

:
AP :

v gg
..vP
Pb jAi g.

Page | 14

CAzs- 4
Pj Dz AS DE 96 2005, AP 10-08-2005
-2
Ut Csy
it v
/w____________________gg U/U /w/w /w Pij ____________
f ___________________vP _______________U___________z Vg
Eg MAz vgUwAz ___________ vgUwAigU ______ f _____ vP
_________ lt
/Uz Ai AU ir________ qz jPA i
GwtgVgvg. F Ai CsyAi AU irz CA i PlPz gU U
CAi, 1976 Cx PlP gsU CAi, 1964g CrAi r
z MAz zq
Ug z, t Ug z Cx jv Avzg z
U
gvz zzv.
()
SzsAig.
gd
Pv Pt
CPj

CAzs- 5
Pq izs AU
it v
/w_________________________________________ gg U/U/w /
w Pij _______________________f _________________ vP ______
U_________________z
Vg
Eg
_________________vgUwAz
_______________vgUwAigU ______________PtP Az __________ PtP
zgU _____________________ Ai Pq izsz AU irgvgAz
itPjVz.
Szsg v AAi g .
AP: _____________
:_______________
Z : - CsyU MAzQA v a U AU irz g v P Pq izs
AU it v P.

Page | 15

CAzs- 6
PlP Pgz CPv e AS: DE 115 2005, AP 19-11-2005
CERTIFICATE FOR THE PERSONS WITH DISABILITIES
This is to certify that Sri/ Smt / Kum Son / wife/
Daughter of Shri ............................... Age............ old, male / female, Registration No................ is
a case of ...................................................... He / She is physically disabled / visual disabled /
speech & hearing disabled and has ........ % ......... percent) permanent(Physical impairment/
visual impairment speech & hearing impairment) in relation to his / her....... ..........................
Note:
1. This condition is progressive / non progressive likely to
improve / not likely to improve.
2. Re-assessment is not recommended / is recommended after a
period of ................ months / years.
* Strike out which is not applicable
Recent attested
Photograph showing
the disability
affixed here)
Sd/
DOCTOR
(Seal)

Sd/
DOCTOR
(Seal)

Sd/
DOCTOR
(Seal)
Countersigned by the
Medical Superintendent CMO Head of
Hospital (with seal)

Signature/Thumb impression
of the disabled person.
Date:

Date:

Explanation:-As

per Notification No. DPAR 50 SRR 2000 dated 03-09-2005 Physically

Handicapped candidates or person with disability means a person suffering from not
less than forty percent of any of the following disabilities :- (1) Blindness (2) Low
Vision (3) Hearing impairment (4) Locomotor disability (5) Leprosy cured (6) Mental
retardation (7) Mental illness.

(1)Blindness refers to a condition where a person suffers from any of the

following conditions, namely:- (a)Total absence of sight; or (b) Visual acuity
not exceeding 6/60 or 20/200 (Snellen) in the better eye with correcting
lenses;
or (c) limitation of the field of vision subtending an angle of 20 degree or
worse;(2) Person with low vision means a person with impairment of visual
functioning even after treatment or standard refractive correction, but who
uses or is potentially capable of using vision for the planning or execution of
a task with appropriate assistive device;(3) Hearing impairment means loss of
sixty decibels or more in the better ear in the conversational range of
frequencies.(4) Locomotor disability means disability of the bones, joints or
muscles leading to substantial restriction of the movement of the limbs or any
form of cerebral palsy.(5) Leprosy cured:-means any person who has been cured
of Leprosy, but is suffering from, (i) Loss of sensation in hands or feet as
well as loss of sensation & paresis in the eye & eyelid, but with no manifest
deformity;(ii)manifest deformity & paresis but having sufficient mobility in
their hands & feet to enable them to engage in normal economic activity; (iii)
extreme physical deformity as well as advanced age which prevents him from
undertaking any gainful occupation; and the expressesion Leprosy cured
shall be construed accordingly; (6) Mental Retardation:-means a condition of
arrested or incomplete development of mind of a person who is specially
characterised by sub normality of intelligence; (7) Mental Illness:- means any
mental disorder other than mental retardation.

Page | 16

CAzs- 7
Pgz CZ AS: rJDg 23 JDgDg 99, AP: 23-11-2000

AidUAz vgz PlAz Cs y

it v
/w -------------- JAg U/U /w/w /w/ Pij ------ f ------------ vP --------- U--------- z Vg Eg : ;Eg PlAzg
CAvgVz F PPAq DAi --------------- AidUV AP---------------AiAz r
P
Vz. JAz F P itPjz: v v CAgVz Cg P sAi Czsz:
AidU z sAi Agz : AidAz v :
v CAvgVz v P sAi Czsz Cx CzQA v Pr P s:
Evg Ez Pgt
z AidAz vgzg

v g
--------vP
(CA iU LlA iv it vz vPz. )

Page | 17

 - 1
dg
jm CsyU g P jA z, zrPj Ut wAi Pg

Pz

it v.
(dg
jm CsyU sw
iq Pz )
EjU:
v gg
_________ vP
_________ f.
ig,
/ w ___________________ JAg U/U/w/w _______ Dz gz
(creamy layer) gA z g PwAi Ut Csy wAi qA izPV it
v qA i v F PPA q iwU MzVv Pgv.
1. CsyAi g v GzU :
2. CsyAi A v
U :
vP :
f :
3. CsyAi nz AP Ai v nz
:
1. CsyAi vAz/v/ Pg wAi/
wAi g v GzU:
(GzU Pj/ Cg Pj/ dP Gz / SV)
2. CsyAi v
(V z)
3. CsyAi SAiA
4. CsyAi Pt
z AU irz U
gU

xP
izsP
qs
5. CsyAi U CsyAi vAz/v/
Pg (vAz/v fAvzg) Eg
Ml P DzAi J UAz:
i) v t
ii) d g
iii) Evg U
6. DzAi vjU wzgg?
7. Av vjU wzgg?
8. igl vjU wzgg?

itPv Wu
F Az MzVz iw / gu
A i wgg nU vAz zPV
zrPjv v Wv.
v zsAi,

:
AP:

(CsyAi )
Page | 18

 MzVz iwU vVgvz JAz

itPjv, F iwU Cv Az
zqs
l

Cgzs ZguU
z
Vgv .
vAz/v/Pg .
(vAz/v
fAvzg )
(Aqw/ UAq/ Eg )

Ai Eg Qzgg :
CsyAi v vAz/v/Pg /w/w Eg
U Eg Ai Ugwv .
Qzgg :
1)
2)
(t zAU)
j
it v
1. / w ___________________ JAg U/U/w/w / w / Pij
_______ JAg PlP gdz __________ fA i sU ____________________
U/ lt
/ Ug z
i AiiVzgA z v Eg dg
jm U P
jzg Vgvg.
/ w / Pij__________ Eg vAz /v/Pg Pj Dz AS:Jqr
251 J 94, AUg, AP: 31-01-1995 gAi dg
jm U z g z

(creamy layer) gA z
itPjVz.
:
AP:

vgg
_______ vP
Pb jAi g.

Z- 1: Ezg
GAiVz `` i `` JA z
1950 g dv wz
PzAi 20 CZ zz

Cx Agvz.
Z 2: j
it v q CPv CPjAi Pj Dz AS: Jqr 251
J 94, AUg, AP:31-01-1995 gAi g (creamy layer)

Page | 19

CAzs- 8
gd Pj/ PAz Pj Pgg MzV Pz
i t v
/ w................................................................................. gg gd / PAz Pgz
........................................................(z) ........................................................................................... ESAi SAiA
/ vvP zAi AP .............................. jAz ........................................... ggU Agg.. F
zU Eg Pw
AiUr
DAiA iiVz, zj zU Cf
CjU Cw qVz.

:
AP:

Pw Pgz /
ESAi g v gAU

CERTIFICATE TO BE FURNISHED BY THE STATE/CENTRAL GOVT.

SERVANTS
Certified that Sri / Smt holds a permanent /
temporary post under the State/Central Govt. as (Designation) in
the dept. of fromhaving been appointed
therein under the rules of recruitment. He /She is permitted to apply for the said post.

Place :
Date:

Signature of the appointing authority

of the department / with name and
seal.

Page | 20