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, A 033 - 2357 - 7930,

Email ID: spmu.nuhm@gmail.com; website: www.wbhealth.gov.in

No. HFW/NUHM-232/2016/64CJ Dated: .(~.?2017

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

To CMOH, Asansol HD / Basirhat Health District / Birbhum / Burdwan / Cooch-Behar / DakshinDinajpur / Darjeeling (SMP)/ Diamond Harbour HD /Hooghly / H~ah / Jalpaiguri. /Jhargram HD /Malda / Murshidabad / Nadia / North 24 Parganas /Nandigram HD/ PaschimMedinipur / Purba Medinipur / Rampurhat HD / South 24 Parganas / 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 names of the Nursing Training 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 makemessing arrangements at their own cost,

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

Enc/o -

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

commisS~FW) &Add}, Mission Director, NHM

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

1. Director of Health Services, WestBengal.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)

Dated:.?'(. ,.2017

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,Ialpaiguri, Ihargram, English Bazar, Old MaIda, Iiaganj- Azimganj, Berhampur, Dhulian, Iangipur,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,

- 3 -

Medinipur, Contai, Haldia, Pan skura, Rampurhat, Baruipur, Budge Budge, Maheshtala, RajpurSonarpur, Islampur, Kaliaganj, Raiganj)

7. PNO, District Hospital, Coochbehar8. PNO, District Hospital, North 24 Pgns9. PNO, Chittaranjan Seva Sadan, 37, SP Mukherjee Road, Kolkata - 70002610. 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 / Teacher-in-Charge, NTS attached to District Hospital, Coochbehar / District Hospital, North

24 Pgns /Chittaranjan Seva Sadanl Howrah District Hospital /Bolpur SD Hospital/ Vidyasagar S.G.Hospital, South 24 Pgns / Kharagpur SD Hospital! 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 / 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.e. is enclosed for ready reference for 7 to 16only.

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

- - - - - -----------------------------------

Format for Submission of Panel for engagement of ANM under NUHM

4

Nameof the District: Howrah

Name of the ULB: HOWRAHMUNICIPALCORPORATION

No of required no. Of trainee: 26 (UR:12,SC:6,5T:2,OBC-A:3,OBC-B:2,PH:1)

SINo

4

x

RABINSARKAR

SOURAV80SE

5UMANTA DAS

KAUSHIKCHATTERJEE

x

x

Date of Birth

02.11.1990

13.07.1990

05.11.1987

x

30.12.1988

Cast

sc

x

Year of TotalPassing Marks

2008

2008

2006

2006

x

500

500

1000

x

500

Details of (10+2) ExaminationMarks obtained in finalExamination (best 5 % of marks

subjects)

269

354

634

x

279

53.80

70.80

63.40

x

55.80

RankBoard/Institute

x

SC W.B.C.H.S.E

Name of the Candidate Gurdian's Name

1 PARAMITADAS(SARKAR)

2 AMRITA BOSE(KARAR)

3 ARPITADA5 (SAMANTA)

x

5 MUNMUN CHATTERJEE

Address with phone Number

144/4/1 SASTRINARENDRANATHGANGULYROAD,PO-SANTRAGACHI,HOWRAH-711104, Phone No:905108638932/1, BHOLANATHKABIRAJLANE,KADAMTALA,HOWRAH-711101, PhoneNo: 9874349265

3, KAILASHBANERJEELANE,HOWRAH-711101, Phone No: 9674297194

x

BALlTlKURICHAKPARA,PO- BALITIKURI,PS-DASNAGAR,DIST-HOWRAH, PIN-711113, Phone No; 9088621303

W.B.C.H.S.E

UR W.B.C.H.S.E

Remarks

No Candidate FoundThus Vacant

6 x )( x x OBC·A

UR W.B.C.H.5.E

x x x x No Candidate FoundThus Vacant

7 SULEKHAMANDALSOUMYABRATADAS

12/1/1/2, NABIN 5ENAPATILANE,PS­SHIBPUR,PIN-711101, Phone No:7278322407

18.12.1981

ST x

1999 1000 455 45.50 7

8 rron BHATIACHARYASUKANTABHATTACHARYA

NORTHSHANPUR 'V' ROAD,DASNAGAR,HOWRAH-71110S,Phone No:7890436180

07.02.1990

URJharkhandAcademicCouncil

2007 900 486 54.00 8

SUCHANDRAGHOSH SAlKAT 54/6 BAKSARAROAD,PO- BAK5ARA,PS·

(MUKHERJEE) MUKHERJEE AlC BOSEBOTANICGARDEN,PIN·7111lO,~ __ ~ ~----------~p~ho~n~e~N~o~:~98~3~OS~8~7~5~98~----------~--------~--------~--------~----_+------~----------------4_------------_+-------------~--.---- ~

G.I.P.COLONY.PS-JAGACHA,DI5T- OBC-Btreated as aHOWRAH,PIN -711112, Phone No: 05.05.1984 UR W.B.C.H.S.E 2001 1000 479 47.90 10 UR due to higher9233120151 marks

9

10 PAMPA DEBNATH BUOY DEBNATH

25.08.1991 OBC-B

URBihar SchoolExamination

Board

2009 500 346 69,20 9

11 x )( x x

W.B.C.H.5.E

SC x x x x x 11No Candidate Found

Thus Vacant

12 x x x x PH x x x x x 12 No Candidate FoundThus Vacant

13 x x x x OBC·A x x x x x 13 No Candidate FoundThus Vacant

14 IVI MANIKNITYANANDANAGAR(WEST)PO-D. 5.

INDRANILMANIK LANE,DIST-HOWRAH, PIN·711109,Phone No: 9903418035

10.07.1985 UR W.B.C.H.S.E 2004 1000 467 46.70 14

15 x x SC x x x x 15 No Candidate FoundThus Vacant

Format for Submission of Panel for engagement of ANM under NUHM ~Name of the District: Howrah

Name ofthe ULB: HOWRAH MUNICIPAL CORPORATION

No of required no. Of trainee: 26 (UR:12, SC:6, ST:2, OSC-A:3, OBC-8:2, PH:l)

DEBALINASINGHAROY( OIBAKARSINGHAJAGACHAFOOLBAGAN, G.I.P. COLONY,

16 HOWRAH-711112, Phone No: 30.06.1987 UR W.B C.H.S.E 2004 1000 465 46.50 16SINHA) ROY9846505535C/O-BANSHIBADAN GHOSH,BALITIKURI

OBC-B treated as a17 SHUBHRAGHOSH DIPAK GHOSHPARA,PO· BAUTIKURI,PS-

23.01.1986 UR W.B.C.H.S.E 2003 1000 465 46.50 17 UR due to higherCHATIERJEE DASNAGAR,DIST·HOWRAH, PIN-711113,marksPhone No:

No Candidate Found18 X X X X SC X X X X X 18Thus Vacant

19 PRIYASARKAR PRODYOTSARKARC.T.I KASHIPURDASNAGAR,HOWRAH-5,

26.07.1989 OBC-B W.B.C.H.S.E 2006 1000 620 62.00 19Phone No: 8479905930/8479905929

20 SUSANDHAMONDALSUSANTA 68/2/2, LAKSHMANDAS LANE,HOWRAH-

16.11.1989 UR W.B.C.H's.E 2009 500 216 43.00 20MONDAL 711101, Phone No: 8013927895

SC 21No candidate Found21 X X X X X X X X X

Thus Vacant

12, KUCHILGH05AL LANE,FLATNO-l1,West Bengal

RE5HMICHATIERJEE Council of22 PRABIRSAMANTA PO-KADAMTALA,PS-BANTRA,HOWRAH- 03.12.1987 UR 2015 1000 400 40,QO 22SAMANTA711101, Phone No: 9433923905 Rabindra Open

Schooling31. A/3 KAMINI SCHOOLLANE,SALKIA,

23 SILPIHAZRA SUKANTAHAZRA HOWRAH, PIN-7U106, Phone No: 03.06.1986 UR W.B.C.H.S.E 2004 1000 388 38.80 239836926036

24 24No Candidate FoundX X X X ST X x X X X

Thus Vacant

25 DEBJANI(DEY)PODDAR CHANDAN DEY 40/10, DANESHSK.LANE,HOWRAH-03.08.1984 UR W.B.C.H.s.E 2005 1000 384 38.40 25711109, Phone No: 9830589491

26 No Candidate FoundX X X X OBC-A X X X X X 26Thus Vacant

~L~ /;1 ,t~" @f<foW;~

c..'" ~~, yj.~., U?t 1 ,"" -"""'...-""'''''l\. __

~;- _"('(:' ' N-' ""...- ,\.' Signature of he Hon'bleSignature 0tRl19r'lS~IY,e,ot:thQ,1 ' Dgnete of the DPHNO Signature ofthe Mayorl signatur; of the DY:SM<miA~,\) '\ Signature of the~oYi/ Chair Person of the Recruitm nt Committee of the District

"\~ \' ,', ", a! t'l "~rnNil~ ,!>,i~h;~~ar& b~te '", \District M.I IS hite with Sea! I!<fOi\t8' 8. \ ~MIC Health, HMC' wlt~'S¢!lk~b~t~ l' ' with S,eal~DateHeo\\.\'\ ~),;,./' \;;',)),C&\ V" i)\.\>,~ , \.:',-\1\\J ~,> )1'(\uv'C}~l~)'

\"....; .~,:~,

.\.,

Format for Submission of Panel for engagement of ANM under NUHM

Name of the District: Howrah

Name of the UlB: UlUBERIA MUNICIPAUTY

No of required no. Of trainee: 8 (UR:4, 5C:2, ST:1, OBC-A: 1)

Details of (10+2) ExaminationMarksobtained in

SINo Name of the Candidate Gurdian's Name Address with phone Number Date of Birth Cast Year of final RemarksBoard I InstitutePassing Total Marks

Examination % of marks Rank

(best 5suliects)

WESTilURIKHAU, PO- BURIKHALI,PS-1 BARNAUBAG (MANNA) SUJITMANNA BAURIA,DIST-HOWRAH,PIN-711310, 06.01.1988 SC W.B.C.H.S.E 2005 1000 571 57.10 1

Phone No: 8981858365

SUBHANKAR BAHIRTAFA,PQ·JADUBERIA,PS·2 RAJASHREEADHIKARY ULUBERIA,DIST-HOWRAH,PIN·711316, 24.04.1990 UR W.B.C.H.S.E 2007 500 326 65.20 2ADHIKARY

Phone No:KAJIRCHARA.PO-DASBAGA,PS-BAURIA,

3 MOUSUMI JANA SUBHASlANA DIST-HOWRAH,PIN-711307, Phone No: 19.10.1987 UR W.B.C.H.5.E 2005 1000 516 51.60 39143096273

X X X X X 4 No Candidate Found4 X X 5T X XThus Vacant

BAZARPARA(NEARMOSSIONHOUSE),PO West Bengal

f" PRANATICHAKRABORTY SANKARULUBERIA(R.S),DIST-HOWRAH, PIN- 08.09.1986 UR

Council of2011 1000 482 48.20 5CHAKRABORTY

711316, Phone No: 9836124413 Rabindra OpenSchooling

OBC-A X X 6No Candidate Found6 X X X X X X X

Thus Vacant

7 No Candidate Found7 X X X X SC X X X X XThus Vacant

WASIMAKRAM BAURIASEPAlPARA,PO-BAURIA, PS-t JHUMA MAURYASEPAl BAURIA,DI5T-HOWRAH, PIN·711305, 30.03,1985 UR W.B.C.H.S.E 2004 1000 468 46.80 8SEPAl

Phone No: 9883343949

~ ""K~) ./---;::;::::::';?" £ Afr/~'

QlL..Ql/It .. : (// _,.,P'"Signature of e Hon'ble• ~..,Q.LU. ~'~:Q. »' /""#,,, \A'~7'/ Chair Person of the Recruitment

Jl~r;gIOh~epreseiit~ of the dl!f":u t~ 0 Chirperson, Uluberia Signatu';e of the Dy.CMqH-1 ~'~')ft~\ . ' \\\.tCommittee of the Dis'ttict with SealSignature of thef~e!h' '

ct Maglst~l & Date • wiih 5eaJ.B.Diae Municipality with Seal B!,,Qi~~~f\ti.kf, with Seal.&(O te (\" \ '.',1;; ~at~, •....,", •\\U'P··· ; d.l ;';iJi. ,/ »-: '--""'." "' ~.'

'>--~ .' ..

51.No. District

Annexure I

ULBwise Number of ANM & Training Institute

ULBrequiredNumber selectedof trainee for 1st numberof

phase traineeTraining Institute Residential!Non­

residential

Non-residentialNon-residential

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