APPLICATION FOR THE POST OF MEDICAL OFFICER UNDER OFFICE OF ADMINISTRATIVE MEDICAL OFFICER, E,MPLOYEES STATE INSURANCE SOCIETY

INTERVIEW FOR POST OF MEDICAL OFFICER

Details of Posts as below

Post & Places Open EWS SC ST VJNT NT NT NT SBC OBC (A) (B) (c) (D) MEDTCAL OFFICER Total Post 3l (Kuruli/Chakan 2, Wagholi B 4 4 J 1 1 1 1 1 7 2, Khed-Shivapur 2, / markal 2, / 2, 2, I Kurdumbh 2, Rajangaon 2, Sanaswadi/ 2. Shirur 2, Rajgurunagar 2, Talegaon MIDC 2. Lonawala 2. / Paud 2, Marunji / Hinjewadi 2, Kagal 1) MEDICAL OFFICER Total Post 04

(AMO, Pune 2, Sp. Centre 6 4 1 1 1 Pune l, Kupwad l) (Total 4 post will be filled out of 13 sanctioned vacant posts)

Qualification : M.B.B.S Age: Should be less than 57 yrs as on 01.08.2021 Selection Of Procedure: Applications are to be submitted in the prescribed Proforma a) Selection will be made on basis of interview of candidate, which will be conducted by the duly constituted selection committee. b) The final selection will be based purely on performance in personal interview c) If eligible candidates from respective categories are not available then other eligible candidates will be considered. Pay allowances: Candidates appointed on contractual basis will be paid consolidated Pay as per Maharashtra Govemment GR dated 2910512020

General Condition: a) Interview will be conducted at ..OFFICE OF ADMINISTRATIVE MEDICAL OFFICER, GROUND FLOOR, PANCHDEEP BHAVAN, Sr. No. 689/90, BIBVEWADI, PUNE - 411037." Candidate should be present at interview with Original certificates. Interview date will be informed to candidates on e-mail. b) No TA/DA will be admissible for interview or Joining. c) This appointment will be only on temporary basis and no claim for permanent service, any services like PF, Pension, gratuity, Medical allowances, Seniority, Prornotion. Only maximum seven days casual leave will be permitted. d) Other terms and conditions will be applicable as issued by Maharashtra government and competent authority from time to time e) if candidate wishes to resign, candidate should give one month notice 0 Selected candidate will be required to deposit a Security Deposit of One month payment in favor of Administrative Medical Officer, MH-ESIS, Pune at a time of Joining which is refundable after cornpletion of contract period and production of "No Dues Certificate". g) Selected candidate shall be appointed on purely contractual basis for the maximum Period of 364 days. h) No private Practice is allowed during the tenure of service in MH-ESIS. i) Providing Police verification and Medical fitness certificate will be responsibility of this candidate. j) The MH-ESIS reserves the right to cancel the recruitment process at any stage at its discretion and such decision will be binding on all concerned. k) The contractual engagement may be terminated /discontinued on either side after giving one month prior notice to this effect without assigning any reason. l) Knowledge of and Handling of Computer is essential. APPLICATION FOR THE POST OF MEDICAL OFFICER UNDER OFFICE OF ADMINISTRATIVE MEDICAL OFFICER, PUNE MAHARASHTRA EMPLOYEES STATE INSURANCE SOCIETY

INTERVIEW FOR POST OF MEDICAL OFFICER

1. Name in full (in block letters)

2. Fathers/Husband's Name

3. Date of Bifth (DD/MM/YYYY)

4. Religion

5. Caste

6. Category :

7. Mailing address: ......

8. (a) E-Mail : ...... ( b) Mobile No. : ...

9. Residential address

10. Permanent address: ..

1 1. Sex: Male / Fernale

12. Date of Registration in State medical council:

13. Essential Educational and Professional ualification raduate level onwards Name & address of university Duration Degree/ Subject Percentage colledge From To Examination of Marks Passing year obtained e-

1 4. Preferred Location:

Sr. No. Place

1

2

Ja

DOCUMENTS TO RF],OtilRED:

1. Valid MCI / State medical council registration cefiificate 2. Matriculation Cerlificate for Age Proof 3. Proof of Educational Qualification 4. Caste Cefiificate / Caste Validity 5. Experience Certif-rcate (if available) 6. Copy of Pan card, Aadhar card Xerox l. Two Photographs All copies of above documents are to be self attested before submission.

I hereby declare that all the statements made in this application are true, complete and correct to the best of rny knowledge and belief. I understand that in the event of any information being found false or incorrect at any stage, ffiy candidature / appointment shall be liable to be cancelled / tenninated summarily without notice or any compensation in lieu thereof.

Place: Signature of Candidate

Date: