Format of Test-Check Report under ADIP Scheme Test Check (Minimum of 10/15 percent*) of beneficiaries assisted during the year 2017-18 Name of the Implementing Agency - SVNIRTAR, Olatpur

PART-I State: District:

Sl. Name of Benificiary Father's/H Male/ Age Complete Address Conta Type of Place of Camp Date of Date of Test

No. usband's Femal ct Aid given Camp Check working

name e Numb dertaken check(e.g. check(e.g.

er distribution

confirmed & confirmed

Whether any

coveredBeni.

confirmed but confirmed

Findingtest- of

well/distribution

surgical correctionsurgical Sl. No. Sl. the of list of 1 2 3 4 5 6 7 8 9 10 11 12 13 14 AT/PO NISHA DSIT 7894561628 DISTRIBUTION 1 1 ROSALIN NAIK F 11Y - - RT. TAL

CONFIRMED

23.02.2018 23.02.2018

AT KHANDAPADA PO KASAPANGI DIST 9437694026 DISTRIBUTION 2 2 MAMA SWAIN F 11Y - - BHUBANESWAR LT. TAL

CONFIRMED

23.02.2018 23.02.2018

AT KORADANANDANALI SAHI PO KORADA DIST DISTRIBUTION 3 3 SUPRIYA BEHERA F 8Y ANGUL 9777941990 - - BHUBANESWAR LT. TAL

CONFIRMED

23.02.2018 23.02.2018

AT HARIHARPUR PO MAYARAJHALIA DIST NAYAGARH 8018397886 DISTRIBUTION 4 4 SANTAANU SWAIN M 4Y - - BHUBANESWAR RT. TAL

CONFIRMED

23.02.2018 23.02.2018

AT PANIOLA PO BALARAMPRASAD DIST ANGUL 9861803456 DISTRIBUTION 5 5 M 6Y - - BHUBANESWAR RT PMSTR

CONFIRMED

23.02.2018 23.02.2018 SESHADEVA BHOI AT PATHARAPUNJIPURA PO JARAPADA DIST ANGUL 7077587225 DISTRIBUTION 6 6 CHIKI MUKHI F 6Y - - BHUBANESWAR RT TAL

CONFIRMED

23.02.2018 23.02.2018 AT/PO ICHANDAPADA DIST NAYAGARH DISTRIBUTION 7 7 GOUTAM PADIHARI M 6Y 7077587225 - - BHUBANESWAR LT PMSTR

CONFIRMED

23.02.2018 23.02.2018

AT SENENABEDA PO MAHIDHANPUR DIST ANGUL 7436925196 DISTRIBUTION 8 8 SUPRIYA NAIK F 5Y - - BHUBANESWAR BIL PMSTR

CONFIRMED

23.02.2018 23.02.2018

AT MARATIRA PO TUBEY DIST ANGUL DISTRIBUTION 9 9 SURYANARAYAN BARIK M 3Y 7609017721 - - BHUBANESWAR RT. PMSTR

CONFIRMED

23.02.2018 23.02.2018

AT BALINALI PO KOSALA DIST ANGUL 738172483 DISTRIBUTION 10 10 BABU SAHOO M 2Y - - BHUBANESWAR RT. PMSTR

CONFIRMED

23.02.2018 23.02.2018

AT /PO DALIJODABERAHAMPUR DIST 9937631076 NEGELETED DISTRIBUTION 11 11 BABULA LENKA M 10Y - - BHUBANESWAR

CTEV TRIPLLE CONFIRMED

23.02.2018 23.02.2018

Format of Test-Check Report under ADIP Scheme Test Check (Minimum of 10/15 percent*) of beneficiaries assisted during the year 2017-18 Name of the Implementing Agency - SVNIRTAR, Olatpur

PART-I State: ASSAM District: GUWAHATI Sl. Name of Benificiary Father's/H Male/ Age Complete Address Conta Type of Place of Camp Date of Date of Test No. usband's Femal ct Aid given Camp Check

name e Numb dertaken

er

notyetc. confirmed

Finding of test-check(e.g. Findingtest-check(e.g. of

well/distributionbut confirmed

Whether any surgical correction

Sl. No. Sl. the of list covered of Beni.

distribution& confirmed working qualitynot satisfactory/distribution 1 2 3 4 5 6 7 8 9 10 11 12 13 14 C/O PRATAL KALETA AT GITANAGAR GH4 DIST DISTRIBUTION 1 1 HIMAN KALETA - M 2.6Y - - GUWAHATI 06.03.2018 BIL ADDUCTOR 07.03.2018 KAMSUP STATE ASSAM CONFIRMED 7662909022 C/O SAGAT DAS AT MASAKALAM PO BIL. HAMIS DISTRIBUTION 2 2 SUGHAMETSA DAS - F 4Y - - GUWAHATI 06.03.2018 07.03.2018 AHAMGIRI ASSAM RELEASE CONFIRMED 8134078847 C/O BHAGNDLTABAS AT/PO KAHILIPASA PS DISTRIBUTION 3 3 FARSUDAL ISLAM - M 8Y - - GUWAHATI 06.03.2018 TA LT. 07.03.2018 KAMSUP ASSAM CONFIRMED 9101462240 C/O RANJET BHASALI AT UPPES TALUKBASI PO BIL. TA WITH DISTRIBUTION 4 4 NIHA BHASALI - F 9Y GANAREPARA DIST - - GUWAHATI 06.03.2018 STRAYERS 07.03.2018 SONIFPUR ASSAM ASSAM RELEASE CONFIRMED 8876068857 C/O RUMI BEGAM AT BIL HANS WITH SIJUBANI PO HAFIGAON DISTRIBUTION - F 6Y - - GUWAHATI 06.03.2018 GRACILIES 07.03.2018 5 5 DIST KAMREUP STATE RELEASED CONFIRMED ANSUMA BEGUM ASSAM 9846449709 C/O LORONCE HEMRAON AT PUBORUGAON GHY BIL HANS WITH DISTRIBUTION 6 6 ABHIJIT DAIMARI - M 11Y DIST KUMRUP STATE - - GUWAHATI 06.03.2018 GRACILIES 07.03.2018 ASSAM 9101162240 RELEASED CONFIRMED

C/O SAFAR RAHMAN AT SHILIGHAGRI PO BIL HANS WITH DISTRIBUTION 7 7 SABANA YASMIN - F 13Y DAKSHMI BIJIN DIST - - GUWAHATI 06.03.2018 GRACILIES 07.03.2018 BONGAIGAON STATE RELEASED CONFIRMED ASSAM 9957892401

Format of Test-Check Report under ADIP Scheme Test Check (Minimum of 10/15 percent*) of beneficiaries assisted during the year 2017-18 Name of the Implementing Agency - SVNIRTAR, Olatpur

PART-I State: ODISHA District: Sl. Name of Benificiary Father's/H Male/ Age Complete Address Conta Type of Place of Camp Date of Date of Test No. usband's Femal ct Aid given Camp Check

name e Numb dertaken

er

notyetc. confirmed

Finding of test-check(e.g. Findingtest-check(e.g. of

well/distributionbut confirmed

Whether any surgical correction

Sl. No. Sl. the of list covered of Beni.

distribution& confirmed working qualitynot satisfactory/distribution 1 2 3 4 5 6 7 8 9 10 11 12 13 14 C/O GOURANGA CH. SAHOO AT DHAMNAGAR DISTRIBUTION 1 1 BHAGIRATHI SAHOO - M 1.5Y DIST BHADRAK ODISHA - - BHADRAK 22.03.2018 PMSTR BIL 24.03.2018 CONFIRMED

AT PALASAHI PS DHAMNAGAR DIST DISTRIBUTION 2 2 LITUN JENA M 11M BHADRAK ODISHA - - BHADRAK 22.03.2018 U/L PMSTR LT 24.03.2018 CONFIRMED

C/O GURU SAHAJ AT PIRAHAT BAZAR TIHID DISTRIBUTION 3 3 SAHIK SAHAJ M 3Y BHADRAK ODISHA - - BHADRAK 22.03.2018 RT. PMSTR 24.03.2018 CONFIRMED

C/O BIJAY KU JENA AT BHDHRAK ODISHA DISTRIBUTION 4 4 RIMA MAHALIK F 3Y - - BHADRAK 22.03.2018 LT PMSTR 24.03.2018 CONFIRMED

C/O BHAGIRATHI BEHERA AT BALIGHAT TIHIDI DIST DISTRIBUTION 5 5 SUBHASHREE JENA F 4Y BHADRAK ODISHA - - BHADRAK 22.03.2018 U/L PMSTR RT. 24.03.2018 CONFIRMED

C/O SIBA PRASAD JENA AT PACHHALA DHAMNAGAR DISTRIBUTION 6 6 M 4Y DIST BHADRAK ODISHA - - BHADRAK 22.03.2018 LT. PMSTR 24.03.2018 CONFIRMED ABHISEK BEHERA C/O RAHITA SINGH AT ODISHA DISTRIBUTION 7 7 SUNITA JENA F 5Y - - BHADRAK 22.03.2018 U/L PMSTR RT. 24.03.2018 CONFIRMED

C/O RAHITA SINGH AT BALASORE ODISHA BIL. HANS DISTRIBUTION 8 8 RAJNANDINI SINGH F 5Y - - BHADRAK 22.03.2018 24.03.2018 RELEASE CONFIRMED

C/O SAROJINI ROUT AT BHANDARI POKHARI ADDUCTOR DISTRIBUTION 9 9 PANKAJINI ROUT F 6Y - - BHADRAK 22.03.2018 24.03.2018 LENTHENING CONFIRMED

C/O BUDHIRAM MAHALI AT BASUDEVPUR BHADRAK DISTRIBUTION 10 10 SMRUTIREKHA MAHALIK F 6Y - - BHADRAK 22.03.2018 LT. PMSTR 24.03.2018 CONFIRMED

C/O KALANDI JENA AT SAMCHAND PATRA AT DISTRIBUTION 11 11 SONALI JENA F 7Y DHAMNAGAR BHADRAK - - BHADRAK 22.03.2018 U/L PMSTR RT. 24.03.2018 CONFIRMED

AT ANDARAI TIHIDI BHADRAK DISTRIBUTION 12 12 DIVYAJIT MALIK M 8Y - - BHADRAK 22.03.2018 U/L PMSTR LT 24.03.2018 CONFIRMED

AT BALICHATARI TIHIDI DIST BHADRAK DISTRIBUTION 13 13 ALEKH MALIK M 10Y - - BHADRAK 22.03.2018 RT. TAL 24.03.2018 CONFIRMED

AT JENTULIDIHI DIST DISTRIBUTION 14 14 SUBHASH BEHERA M 17Y BHADRAK - - BHADRAK 22.03.2018 RT TRIPLE 24.03.2018 CONFIRMED

C/O SURENDRA JENA AT GHATAPUR CHANDBALI DISTRIBUTION 15 15 SASMITA JENA F 11Y BHADRAK - - BHADRAK 22.03.2018 LT. TRIPLE 24.03.2018 CONFIRMED

C/O BIDYADHAR MAHALIK BIL. HANSL AND DISTRIBUTION 16 16 RABINDRA MAHALIK M 15Y - - BHADRAK 22.03.2018 24.03.2018 AT BSUDEVPUR BHADRAK TAL CONFIRMED AT BARUA PO TIHIDI DIST BHADRAK DISTRIBUTION 17 17 ANIL NAYAK M 15Y - - BHADRAK 22.03.2018 RT. TAL 24.03.2018 CONFIRMED

AT RATNAKAR BARIK AT DAIPUR DHAMNAGAR BIL. HANS DISTRIBUTION 18 18 DEEPARANI BARIK F 7Y BHADRAK - - BHADRAK 22.03.2018 24.03.2018 RELEASE CONFIRMED

AT JATUALI CHANDBALI BHADRAK BIL. HANS DISTRIBUTION 19 19 JAGA MAHALI M 12Y - - BHADRAK 22.03.2018 24.03.2018 RELEASE CONFIRMED

AT BASUDEVGADA BHADRAK DISTRIBUTION 20 20 MANISHA JENA F 10Y - - BHADRAK 22.03.2018 LT. TRIPLE 24.03.2018 CONFIRMED

AT KANTAPADA SASAN KHAIRIA BALASORE DISTRIBUTION 21 21 KAMALAKANTA PANDA M 1.5Y - - BHADRAK 22.03.2018 BIL. PMSTR 24.03.2018 CONFIRMED

AT BASUDEVPUR BHADRAK DISTRIBUTION 22 22 SANATAN DAS M 14Y - - BHADRAK 22.03.2018 LT. TRIPLE 24.03.2018 CONFIRMED

AT MAUDPUR DHAMNAGAR DIST DISTRIBUTION 23 23 BUNI SETHI F 13Y BHADRAK - - BHADRAK 22.03.2018 RT. TRIPLE 24.03.2018 CONFIRMED

AT BONTH BHADRAK DISTRIBUTION 24 24 ANUSHAG MAKHUD F 14Y - - BHADRAK 22.03.2018 RT. TRIPLE 24.03.2018 CONFIRMED

AT KHANTAKUDALA BASUDEVPUR BHADRAK DISTRIBUTION 25 25 KAILASH JENA M 16Y - - BHADRAK 22.03.2018 RT. TAL 24.03.2018 CONFIRMED