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dk fu.kZ; fy;k x;k gSA mDr fu.kZ; 'kklu }kjk ek0 mPp U;k;ky; ds vkns'k entered in High School Certificate. The candidate will have standard at any stage of Examination.
fnukad&16-01-2019 ds fo:) nk;j fo'ks"k vihy ¼Mh½ la[;k&475@2019 esa ek0 to attach his/her High School or equivalent examination (17) The candidates whose candidature are cancelled, do
U;k;ky; }kjk ikfjr gksus okys vfUre fu.kZ; ds v/khu gksxkA certificate with the application form. No other certificate not remain candidates after the cancellation of candidature,
¼3½ bZ-MCY;w-,l- Js.kh ds vH;fFkZ;ksa }kjk mudh Js.kh dk izek.k&i= dkfeZd shall be acceptable for Date of Birth and if it is not attached therefore the marks of such candidates shall not be
vuqHkkx ds dk;kZy; Kki la- &1@2019@4@1@2002@dk&2@19 Vh-lh-&AA] with the application, it shall be rejected. provided.
fnukad 18-02-2019 ds vuq:i vkosnu djus ds o’kZ ds iwoZ o’kZ dk gh ekU; gksxkA (2) The candidates will have to enclose self attested copies (18) If it is found that a candidate has submitted any forged
of Mark sheets, Certificates & Degrees along with the documents he/she will be debarred from all selections of
(4) The Scheduled Caste, Scheduled Tribes, Other
application form of examination in support of their claims of UPPSC forever and action under relevant articles of
Backward Class, Economically weaker sections (E.W.S.).
Educational Qualifications. If they do not enclose self Bharativa Nyaya Sanhita (BNS) will also be taken against
Dependents of Freedom Fighter, PH. and Ex-Servicemen
attested copies of certificates/ documents in support of their him/her.
candidates who are not the permanent residents of U.P. shall claims, the applications shall be rejected.
not be given the benefit of reservation/age relaxation. (3) The benefit of reservation to the categories of physically GENERAL INSTRUCTION
(5) Candidates of any reserved category, if they want the Handicapped persons of society shall be given only on the 1. In no circumstances, applications of any stage shall be
benefit of reservation, must mention their category/ posts which shall be identified by the Government for their accepted after the last prescribed date and time.
subcategory (one or more than one, whichever) in the Sub category. For this benefit, the Handicapped persons Applications found without requisite Information and without
column related to O.T.R. because all the personal must produce a certificate of being handicapped in that Sub photograph and signature, even when received in time, may
information will be automatically displayed in the application category issued by Medical Officer/Specialist and counter be summarily rejected.
form from the O.T.R. signed by the Chief Medical Officer according to Rule 3 of 2. In the On-line system, the candidates must ensure that all
(6) The Candidates claiming for the benefit of reservation/ U.P. Public Service (Reservation for physically the requisite information have been duly filled and must
age relaxation must obtain, in support of their category a Handicapped, Dependent of Freedom Fighters and Ex- submit by the last prescribed Data & Time. Candidates must
certificate issued by competent authority on the proforma Servicemen (Amendment) Act. 2021. lake the Print and keep it safely. In any discrepancy, the
available on Appendix-1 of the Website of this detailed (4) The Ex-Army Personnels must be discharged from Army candidates will have to produce the said print to the
advertisement and shall submit the same to the upto the last date prescribed for receipt of applications. commission's office otherwise no request shall be
Commission when asked for. (5) Date, time and venue etc. of examination along with Roll entertained.
(7) Candidates claiming reservation/Age relaxation in more No. will be communicated to the candidates through e- 3. Those candidates, willing to take the benefit of the
than one category will be entitled to only one concession, Admit Cards. Candidates will have to appear only at the reservation/ age relaxation must obtain a certificate, issued
whichever is more beneficial to them. centre/ venue allotted to them by the Commission. No by the competent authority, in support of the reserved
(8) In case of women candidate, the caste certificate issued change in centre/venue is permissible and no application category, in the prescribed format printed in this detailed
from father side only will be treated valid. shall be entertained in this regard. advertisement (Appendix-1) and submit the same to the
(9) It is mandatory for the candidates to enclose self-attested (6) The Commission reserves the right of cancelling the Commission, whenever required to do so. Candidate
copies of all the certificates along with the application form candidature of any candidate found indulging in any claiming more than one reservation/age relaxation will be
malpractice i.e. copying in examination hall or indiscipline, given only one such concession, which will be more
in support of the claims made by them in their application
misbehavior or canvassing for his/her candidature etc. On beneficial. The Candidates who are not originally domicile
form of Examination regarding eligibility and category/sub
violation of these instructions, the candidates may be of U.P. belonging to SC, ST, O.B.C., E.W.S.. dependents of
category, failing which their claim shall not be entertained. debarred from this examination as well as future freedom fighters, Ex-Servicemen, Outstanding/Skilled
6. Conditions of eligibility in case of emergency
Examinations and selections. In this regard, decision of the sports person and PH are not entitled to the benefit of
commissioned/short service commissioned officers:- commission shall be final. The Provisions of Uttar Pradesh reservation/age relaxation.
(For age relaxation only). In accordance with the Public Examination (Prevention of unfair Means) Act-2024, In case of the women candidates, the caste certificate
provisions of the G.O. No. 22/10/1976-karmik-2-85, dated dated 06 August, 2024 will be applicable in aforesaid issued from father side will be treated valid.
30-1-1985 Emergency Commissioned / Short Service examination. 4. The Commission do not advise to candidates about their
Commissioned Officers who have not been released from (7) In all communication to the Commission, the candidate eligibility. Therefore, they should carefully read the
Army but whose period of Army service has been extended must mention the name of examination, advertisement No., advertisement and when satisfied about their eligibility as
for rehabilitation, may also apply for this examination on the O.T.R. Number/ Application ID, Name of the candidate. date per conditions of the advertisement, only then apply. The
following conditions: (A) Such applicants will have to obtain of birth, father's/ Husband's name and also the Roll Number candidates must possess all the requisite qualifications till
a certificate of the competent authority of Army/Navy/Air (if allotted), if communicated. the last date for submitting the applications.
Force to the effect that their period of Service has been (8) Candidates selected for appointment will have to 5. In the category of dependents of the freedom fighters only
extended for rehabilitation and no disciplinary action is undergo Medical Examination as required under the Rules. sons, daughters, grandsons (Son's son/Daughter's son)
pending against them. (B) Such applicants will have to (9) Candidates serving under the Central or State and grand daughters (son's daughter/daughter's daughter,
submit in due course a written undertaking that in case they Government will have to produce ‘No objection certificate’ married/unmarried) are covered. It is advised that the
from their employer issued by the competent authority. candidates of aforesaid category must obtain the
are selected for the post applied for, they will get themselves
(10) The candidates who are appearing in the examination reservation certificate from the District Magistrate in terms
released immediately from the Army Service. The above
of essential qualification prescribed for the posts need not of Govt. Order No. 453/79-V-1-15-1(ka) 14-2015, dated
facilities will not be admissible to Emergency/Short Service
apply, because they are not eligible. 07.04.2015 in the prescribed format and submit the same.
Commissioned Officers, if (a) he gets permanent (11) While filling the OMR answer sheets, the candidates 6. In case the candidates feel any problem in the "On-line
Commission in the Army, (b) he has been released from the must use Black Ball Point Pen Only. Use of any other Pen or Application", they may get their problem resolved by
Army on tendering resignation, (c) He has been released Pencil is strictly prohibited. sending their queries to the 'Mail Box' of the commission.
from the Army on grounds of misconduct or physical (12) At the time of examination, candidates must fill all 7. Proforma of caste certificate for different reserved
disability or on his own request and who gets gratuity. the information sought on the OMR Answer Sheet categories are given in Appendix-1, similarly the plan of
7. MARITAL STATUS: Male candidates who are married correctly by blackening the concerned circles, which examination and the syllabus of examination are given in
and have more than one wife living and female candidates are decipherable by the scanner machine. The Appendix-2.
who have married a person already having a wife shall not Commission will evaluate OMR Answer Sheet only on
Detailed Application Form:
be eligible unless the Hon'ble Governor has granted an the basis of information given by blackening the
concerned circles of OMR Answer Sheet. The At the online page there is a 'Declaration' for the candidates.
exemption from this condition. Candidates are advised to go through the contents of the
candidates are also directed not to use whitener, blade,
8. EDUCATIONAL QUALIFICATION:- pin or rubber etc. on the OMR Answer Sheet. In case of Declaration carefully. Candidate has the option to either
Essential- Passed the Intermediate examination with not blackening the circles properly in the OMR Answer agree or disagree with the contents of Declaration by
Diploma in Computer Science from a recognized Sheet and filling any information incorrectly, the clicking on 'I Agree' or 'I do not agree' buttons. In case the
Institute/University or Intermediate with the “O” level Commission shall not evaluate such OMR Answer candidate opts to ‘I do not agree’, the application will be
diploma from DOEACC or NIELIT Society. Sheet for which candidates themselves shall be wholly dropped and the procedure will be terminated. Accepting to
Preferential Qualification- A candidate who has (I) served responsible. agree only will submit the candidate's Online Application.
in the territorial Army for a minimum period of two years, or (13) As per the decision of Hon'ble Commission, the Answer Notification Details
(ii) obtained a “B” certificate of N.C.C., shall other things Sheet used in objective examinations, will be in three This section shows information relevant to Notification i.e.
being equal, be given preference in the matter of direct copies: First copy Original copy-Pink, Second copy Notification number, selection type, directorate/ department
recruitment. Preserved copy-Green and Third copy Candidate's copy- name and post name.
Relevant Service Rules of the Post Blue. After completion of the examination, the invigilator will Personnel Details from OTR
The Uttar Pradesh Public Service Commission submit the Original copy and Preserved copy of OMR
This section shows information about candidate personnel
Answer Sheet; and the candidate will take the third copy
Subordinate Service Regulations, 2006 (as amended). details i.e. OTR Number, candidate name, Father/Husband
(Candidate's copy-Blue) with him/her.
Note:- The candidates must possess all the requisite name, Gender, DOB, UP domicile, Category, Marital status,
(14) In the Examination for the objective type Question
qualifications upto the last date for submitting the papers, penalty (Negative Marking) shall be imposed for email and contact number, photo & signature, address, UP
wrong answers given by the candidates which is as below:- Freedom Fighter, Ex Army, service duration and your
applications.
(i) There are four alternatives for the answer to every physical challenges, Skilled Player, Outstanding Player of
9. AGE LIMIT (I): Candidates must have attained the age of U.P., Debarred candidate.
18 years and must not have crossed the age of 40 years on question. For each question for which a wrong answer has
been given by the candidate, one third (0.33) of the marks Education & Experience Details
July 1, 2025 i.e. they must have not been born earlier than
assigned to that question will be deducted as penalty. (ii) If It shows your educational and experience details
2nd July, 1985 and not later than July 1, 2007. For PH
a candidate gives more than one answer, it will be treated as Declaration segment
candidates, the maximum age limit is 55 years i.e. candidate
must have not been born before 02 July, 1970. a wrong answer even if one of the given answer happens to At the page there is a 'Declaration' for the candidates.
(ii) Relaxation in Upper Age Limit: (a) Upper age limit shall be correct and there will be same penalty as above for that Candidates are advised to go through the contents of the
be greater by five years for candidates belonging to question. (iii) If a question is left blank i.e. no answer is given Declaration carefully.
Scheduled castes of U.P., Scheduled Tribes of U.P., Other by the candidate, there will be no penalty for that question. After filling all above particulars there is provision for
Backward Classes of U.P., Skilled players of U.P. of (15) The minimum efficiency standard for S.C. & S.T. preview your detail before final submission of application
Classified Games and State Govt. Employees of U.P. candidates is fixed 35% i.e. the Candidates of these form on clicking on "Preview" button.
including Teachers/Staff of the Basic Shiksha Parishad of Categories shall not be placed in the merit/select list if they Preview page will display all facts/particulars that you have
U.P. and teachers/staff of the Government Aided have secured less than 35% marks in the examination. mentioned in O.T.R. if you are sure with filled details then
Madhyamik Vidyalayas of U.P. i.e they must have not been Similarly, the minimum efficiency standard for the click on "Submit" button to finally push data into server with
born before 2nd July, 1980. (b) Upper age limit shall be candidates of other categories is fixed 40% i.e. such successfully submission report that you can print.
greater by fifteen years for persons with disabilities (PH) of candidates shall not be placed in the merit/select list If they [CANDIDATES ARE ADVISED TO TAKE A PRINT OF
U.P. (c) Upper age limit shall also be greater by three years + have secured less than 40% marks in the examination. All THIS PAGE BY CLICKING ON THE "Print" OPTION
Period of service rendered in Army for the Emergency such candidates who have secured less marks than the AVAILABLE]
Commissioned Officers / Short Service Commissioned marks of minimum efficiency standard as fixed by the For other information candidates are advised to select
Officers / Ex-Army Personels of U.P. Commission shall be treated disqualified. desired option in 'Home Page' of Commission's website
10. IMPORTANT INSTRUCTIONS FOR CANDIDATES:- (16) The candidates of reserved categories will be adjusted https://uppsc.up.nic.in
(1) The date of birth of the candidates shall be admissible as against the unreserved category in the final selection only If IMPORTANT ANNOUNCEMENT
he/she has not availed any benefit/concession in qualifying
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:- NOTIFICATIONS /ADVERTISEMENTS IV. vf/klwfpr uxjikfydk ls brj 200 oxZ xt vFkok blls with seal with seal with seal
• All Notification/Advertisements vf/kd dk vkoklh; Hkw[k.MA Signature/thumb
:- ONLINE APPLICATION FORMS SUBMISSION impression of the Countersigned by the
• Candidate Registration
2- Jh@Jherh@dqekjh -------------------------------------- tkfr ------------------- ds
person in whose Chief Medical Officer
• Fee Deposition /Reconciliation lnL; gSa tks vuqlfw pr tkfr] vuqlfw pr tutkfr rFkk vU; fiNM+s favour certificate of (with seal)
• Submit Application Form oxksZa ds :i esa vf/klwfpr ugha gSAa disability is issued
• Modify Submitted Application gLrk{kj ------------------¼dk;kZy; dk eqgj lfgr½
• Candidate Dashboard (OTR Based) Form-III
vkosnd dk iwjk uke ------------------------------------------------------------------
:- CANDIDATE'S HELP DESK SECTION Certificate of Disability
ikliksVZ lkbt inuke --------------------------------------------------------------------
• Double Verification mode (In cases of multiple disabilities)
• View Application Status dk vfHkizekf.kr ftykf/kdkjh@vfrfjDr ftykf/kdkjh@flVh (Name and Address of the Medical Authority/Board issuing
• Download Admit Card QksVksxzkQ
eftLVªVs @ijxuk eftLVªVs @rglhynkjA the Certificate) Recent passport size
• Print Duplicate Registration Slip
• Print Detailed Application Form ¼çi=&II½ attested photograph
• List of Applications Having ANY Objections vkfFkZd :i ls detksj oxZ ds ykHkkFkZ Lo;a ?kks"k.kk i= (showing face only) of
• View Answer Key Lo;a ?kks"k.kk i= the person with disability
LAST DATE FOR RECEIPT OF APPLICATIONS: On-line eSa ------------------ iq=@iq=h@iRuh Jh------------------- xzke@dLck ------ Certificate No. Date:
Application process must be completed (including filling up ------------ iksLV vkWfQl ------------------------------ Fkkuk ----------------------- Cykd -------- This is to certify that we have carefully examined
of OTR, Part-I, Part-II and Part-Ill of the Form) before last ---------- rglhy ----------------------------- ftyk ----------------------- jkT; --------------------- Shri/Smt./Kum.___________son/wife/ daughter of
date of form submission according to Advertisement, after
which the web-link will be disabled.
------------------ us vkfFkZd :i ls detksj oxZ ds çek.k i= gsrq vkosnu Shri _____________ Date of birth (DD/MM/ YY) _______
fn;k gS] ,rn~ }kjk ?kks"k.kk djrk@djrh gw¡%& age_____ years, male/ female_________Registration
APPENDIX-1 No.________ permanent resident of House No._________
1. eSa -------------------------------------------- tkfr ls lEcU/k j[krk@j[krh g¡w] tks mRrj
m0iz0 dh vuqlwfpr tkfr rFkk vuqlwfpr tutkfr ds izns'k gsrq vf/klwfpr vuqlwfpr tkfr] vuqlwfpr tutkfr ,oa vU; fiNM+k Ward/Village/Street________ Post Office_______
fy;s tkfr izek.k&i= oxZ dh lwph esa lwphc) ugha gSA District_______ State_______, whose photograph is
izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ------------------ 2-esjs ifjokj dh dqy lzksrksa ¼osru] d`f"k] O;olk;] is'kk bR;kfn½ ls dqy
affixed above, and am satisfied that: (A) he/she is a case of
lqiq=@lqiq=h Jh ------------------------ fuoklh ----------------- xzke -------- rglhy Multiple Disability. His/her extent of permanent physical
okf"kZd vk; : ------------------------ ¼'kCnksa esa½ gSA impairment/disability has been evaluated as per guidelines
---------------- uxj ------------------------ ftyk -------------------------- mRrj izns'k jkT; 3- esjs ifjokj ds ikl mfYyf[kr vk; ds flok; vFkok blds vfrfjDr (......number and date of issue of the guidelines to be
dh ------------------------- tkfr ds O;fDr gSa ftls lafo/kku ¼vuqlwfpr tkfr½ vU;= dksbZ ifjlEifRr ugha gSA specified) for the disabilities ticked below, and is shown
vkns'k] 1950 ¼tSlk fd le;≤ ij la'kksfèkr gqvk½@lafo/kku vFkok against the relevant disability in the Table below,
¼vuqlwfpr tutkfr] mRrj izns'k½ vkns'k] 1967 ds vuqlkj vuqlwfpr dbZ LFkkuksa ij fLFkr ifjlEifRr;ksa dks tksM+us ds i'pkr Hkh eSa ¼uke½ ----------
Permanent
tkfr@vuqlwfpr tutkfr ds :i esa ekU;rk nh xbZ gSA ----------------------- vkfFkZd :i ls detksj oxZ ds nk;js esa vkrk@vkrh g¡wA Affected physical
4- eSa ?kks"k.kk djrk@djrh g¡w fd esjs ifjokj dh lHkh ifjlEifRr;ksa dks S. Diagno impairment/
Jh@Jherh@dqekjh ------------------------------------------------- rFkk@vFkok part of
tksM+us ds i'pkr~ fuEufyf[kr esa ls fdlh Hkh lhek ls vf/kd ugha gS%& N. Disability sis mental disability
mudk ifjokj mRrj izns'k ds xzke ---------------------- rglhy ---------------------- body
(in%)
I. 5 ¼ikWap½ ,dM+ d`f"k ;ksX; Hkwfe vFkok mlls ÅijA
uxj -------------------------- ftyk ---------------------- esa lkekU;r;k jgrk gSA 1. Locomotor disability @
II. ,d gtkj oxZ QhV vFkok blls vf/kd {ks=Qy dk ¶ySVA
LFkku -------------------------- gLrk{kj--------------------------- 2. Muscular Dystrophy
III. vf/klwfpr uxjikfydk ds varxZr 100 oxZ xt vFkok blls
fnuakd ----------------------- iwjk uke-------------------------- 3. Leprosy cured
vf/kd dk vkoklh; Hkw[k.MA
eqgj --------------------------- in uke---------------------------- IV. vf/klwfpr uxjikfydk ls brj 200 oxZ xt vFkok blls 4. Dwarfism
ftykf/kdkjh@vfrfjDr ftykf/kdkjh@flVh eftLVsªV@ijxuk vf/kd dk vkoklh; Hkw[k.MA 5. Cerebral Palsy
eftLVsªV@rglhynkj@vU; osru Hkksxh eftLVsªV] ;fn dksbZ eSa çekf.kr djrk@djrh gw¡ fd esjs }kjk mijksDr tkudkjh esjs Kku vkSj 6. Acid attack Victim
gks@ftyk lekt dY;k.k vf/kdkjhA fo'okl ds vuqlkj lR; gS vkSj eSa vkfFkZd :i ls detksj oxZ ds fy, 7. Low Vision #
mÙkj izns'k ds vU; fiNM+s oxZ ds fy, tkfr izek.k&i= vkj{k.k lqfo/kk çkIr djus gsrq ik=rk /kkj.k djrk@djrh gw¡A ;fn esjs }kjk 8. Blindness #
izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ------------------ lqiq=@ nh xbZ tkudkjh vlR;@xyr ik;h tkrh gS rks eSa iw.kZ :i ls tkurk
Deaf £
lqiq=h Jh------------------ fuoklh xzke------------------ rglhy ------------------ uxj -- gw¡W@tkurh gw¡ fd bl vkosnu i= ds vk/kkj ij fn;s x;s çek.k i= ds }kjk 9.
10. Hard of Hearing £
----------- ftyk ----------------- mRrj izns'k jkT; dh -------------------- fiNM+h 'kS{kf.kd laLFkku esa fy;k x;k ços'k@yksd lsokvksa ,oa inksa esa izkIr dh xbZ
Speech and
tkfr ds O;fDr gSaA ;g tkfr m0iz0 yksd lsok ¼vuqlwfpr tkfr;ksa] fu;qfDr fujLr dj nh tk;sxh@dj fn;k tk;sxk vFkok bl çek.k i= ds 11.
Language disability
vk/kkj ij dksbZ vU; lqfo/kk@ykHk çkIr fd;k x;k gS mlls Hkh oafpr fd;k
vuqlwfpr tutkfr;ksa rFkk vU; fiNM+s oxksZa ds fy;s vkj{k.k½ 12. Intellectual Disability
tk ldsxk vkjS bl lEcU/k esa fof/k ,oa fu;eksa ds v/khu esjs fo:) dh tkus
vf/kfu;e] 1994 ¼;Fkkla'kksf/kr½ dh vuqlwph&,d ds vUrxZr ekU;rk 13. Specific Learning
okyh dk;Zokgh ds fy, eSa mRrjnk;h jgw¡xk@jgw¡xhA Disability
izkIr gSA uksV%& tks ykxw ugha gks mls dkV nsaA
;g Hkh izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ------------- 14. Autism Spectrum
LFkku %& vkosnd@vkosfndk dk gLrk{kj rFkk iwjk ukeA Disorder
--------------- iwoksZDr vf/kfu;e] 1994 ¼;Fkkla'kksf/kr½ dh vuqlwph&nks fnukad%&
tSlk fd m0iz0 yksd lsok ¼vuqlwfpr tkfr;ksa] vuqlwfpr tutkfr;ksa 15. Mental illness
m0iz0 ds fnO;kax O;fDr;ksa ds fy, izek.k&i= 16. Chronic Neurological
vkSj vU; fiNM+s oxksZa ds fy;s vkj{k.k½ ¼la'kks/ku½ vf/kfu;e] 2001 ¼fnO;kaxtu izk:i½ Conditions
}kjk izfrLFkkfir fd;k x;k gS ,oa tks m0iz0 yksd lsok ¼vuqlwfpr Form-II 17. Multiple sclerosis
tkfr;ksa] vuqlwfpr tutkfr;ksa vkSj vU; fiNM+s oxksZa ds fy;s Certificate of Disability 18. Parkinson's disease
vkj{k.k½ ¼la'kks/ku½ vf/kfu;e] 2002 }kjk la'kksf/kr dh x;h gS] ls (In cases of amputation or complete permanent paralysis of 19. Haemophilia
vkPNkfnr ugha gSA buds ekrk&firk dh fujarj rhu o"kZ dh vof/k ds limbs or dwarfism and in case of blindness) Name and 20. Thalassemia
fy;s ldy okf"kZd vk; vkB yk[k #i;s ;k blls vf/kd ugha gS rFkk Address of the Medical Authority issuing the Certificate. 21. Sickle Cell disease
buds ikl èkudj vf/kfu;e] 1957 esa ;Fkk fofgr NwV lhek ls vf/kd Recent passport size
lEifRr Hkh ugha gSA attested photograph (B). In the light of the above, his/her over all permanent
(showing face only) of physical impairment as per guidelines (.......number and
Jh@Jherh@dqekjh ------------------------------- rFkk@vFkok mudk the person with disability date of issue of the guidelines to be specified), is as follows:
ifjokj mRrj izns'k ds xzke --------------------------- rglhy -------------------------- In figures................percent.
uxj ------------------------ ftyk ------------------------ esa lkekU;r;k jgrk gSA Certificate No. Date: In words............................................................percent
LFkku -------------------------- gLrk{kj ----------------------------- This is to certify that I have carefully examined 2. This condition is progressive/non-progressive/likely to
Shri/Smt./Kum._____________son/wife/daughter of improve/not likely to improve.
fnuakd ----------------------- iwjk uke ----------------------------- 3. Reassessment of disability is:-
Shri__________Date of Birth (DD/MM/YY)________Age
eqgj --------------------------- in uke ----------------------------- ____years, male/female___________ registration No. (i) not necessary,
ftykf/kdkjh@vfrfjDr ftykf/kdkjh@flVh eftLVsªV@ijxuk __________permanent resident of House No. or
(ii) is recommended/ after............ years............ months,
eftLVsªV@rglhynkjA _ _ _ _ _ _ _ _ Wa r d / V i l l a g e / S t r e e t _ _ _ _ _ _ _ _ _ P o s t
and therefore this certificate shall be valid till.... ...... .....
office_________ District________State__________.
¼çi=&I½ (DD) (MM) (YY)
whose photograph is affixed above, and am satisfied that: @ -e.g. Left/right/both arms/legs
mRrj çns'k ljdkj (A) he/she is a case of: # - e.g. Single eye
dk;kZy; dk uke----------------------------------------------vkfFkZd :i nIocomotor disability £ - e.g. Left/Right/both ears
ls detksj oxZ ds lnL; }kjk izLrqr fd;k tkus ndwarfism 4. The applicant has submitted the following document as
okyk vk; ,oa ifjlEifRr izek.k&i= nblindness proof of residence:-
çek.k i= la[;k------------------- fnukad -------------------- (Please tick as applicable) Nature of Date of Details of authority
(B) The diagnosis in his/her case is_________ Document Issue issuing certificate
foRrh; o"kZ ---------------- ds fy, ekU; © he/she has ________% (in figure)________percent
çekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh----------------------------------- (in words) permanent locomotor disability/
------ iq=@ifr@iq=h Jh----------------------------------- xzke@dLck---------------------------- 5. Signature and seal of the Medical Authority
dwarfism/blindness in relation to his/her______ (part
iksLV vkfQl
W ---------------------------- Fkkuk ------------------------------ rglhy ------------------------- of body) as per guidelines (.............number and date
of issue of the guidelines to be specified). Name and Seal Name and Seal Name and Seal
--- ftyk ------------------------------------ jkT; -------------------------- fiu dksM -----------------------
2. The applicant has submitted the following document of Member of Member of the Chairperson
ds LFkk;h fuoklh gSa] ftudk QksVksxzkQ uhps vfHkçekf.kr gS] vkfFkZd
as proof of residence:- Signature/thumb
:i ls detksj oxZ ds lnL; gSa] D;ksafd foRrh; o"kZ -------------------- esa buds
Nature of Date of Details of authority impression of the Countersigned by the
ifjokj dh dqy okf"kZd vk; 8 yk[k ¼vkB yk[k :i;s ek=½ ls de gSA buds Document person in whose Chief Medical Officer
Issue Issuing certificate
ifjokj ds LokfeRo esa fuEufyf[kr esa ls dksbZ Hkh ifjlEifRr ugha gS%& favour certificate of (with seal)
I. 5 ¼ikWp a ½ ,dM+ d`f"k ;ksX; Hkwfe vFkok mlls ÅijA disability is issued
II. ,d gtkj oxZ QhV vFkok blls vf/kd {ks=Qy dk ¶ySVA
3. Signature and seal of the Medical Authority.
(Dr...............) (Dr...............) (Dr...............) Form-IV
III. vf/klwfpr uxjikfydk ds varxZr 100 oxZ xt vFkok Certificate of Disability
Member Member Chairperson (In cases of other than those mentioned in Forms
blls vf/kd dk vkoklh; Hkw[k.MA Medical Board Medical Board Medical Board
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II and III ) dq'ky f[kykfM+;ksa ds fy;s izek.k&i= tks m-iz- ds ewy vkRet@iRuh@vkRetk Jh ------------------------------------------- fuokl ¼iwjk
(Name and Address of the Medical Authority/Board fuoklh gSa irk½ ------------------------------------ esa ----------------------------- Ldwy esa d{kk ---------------
issuing the Certificate)
'kklukns'k la[;k&22@21@1983&dkfeZd&2 ds fo|kFkhZ us fnukad ------------------- ls fnukad ------------------- rd ------------------
Recent passport size ¼LFkku dk uke½ esa vk;ksftr Ldwyksa ds us'kuy xsEl dh ------------------------
fnukad 28 uoEcj] 1985 izek.k&Ik= ds QkeZ & 1 ls 4
attested photograph
izk:i &1 ¼ØhM+k@[ksy&dwn dk uke½ izfr;ksfxrk@VwukZesUV esa ---------------------------
(showing face only) of
¼ekU;rk izkIr ØhM+k@[ksy esa vius ns'k dh vksj ls vUrjkZ"Vªh; Ldwy dh vksj ls Hkkx fy;kA muds Vhe ds }kjk mDr izfr;ksfxrk@
the person with disability
izfr;ksfxrk esa Hkkx ysus okys f[kykM+h ds fy;s½ VwukZesUV esa ------------------------- LFkku izkIr fd;k x;kA
Certificate No. Date: lEcfU/kr [ksy dh jk"Vªh; QsMjs'ku@jk"Vªh; ,lksfl,'ku dk ;g izek.k&i= MkbjsDVªsV vkWQ ifCyd bUlVªD'kUl@f'k{kk esa
This is to certify that I have carefully examined uke --------------------------- jkT; ljdkj dh lsokvksa@inksa ij fu;qfDr ds miyC/k fjdkMZ ds vk/kkj ij fn;k x;k gSA
Shri/Smt./Kum.___________son/wife/daughter of
Shri _____________ Date of birth (DD/MM/ YY) _______
fy, dq'ky f[kykfM+;ksa ds fy, izek.k&i=A LFkku -------------------------- gLrk{kj -------------------------------------
age_____ years, male/ female__________ izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ------------------------ fnuakd ----------------------- uke ---------------------------------------------
Registration No.__________permanent resident of House vkRet@iRuh@vkRetk Jh --------------------- fuoklh ---------------------- iwjk in ----------------------------------------------
No. ________ Ward/Village/ Street________Post irk ----------------- us fnukad ------------------- ls fnukad ------------------ rd -------------
Office_______District________ State_______, whose laLFkk dk uke --------------------------
photograph is affixed above, and am satisfied that he/she is -------- ¼LFkku dk uke½ esa vk;ksftr------------------------ ¼ØhM+k@[ksy&dwn eqgj -------------------------------------------
a case of ___________ disability. His/her extent of dk uke½ dh izfr;ksfxrk@VwukZesUV esa ns'k dh vksj ls Hkkx fy;kA uksV % ;g izek.k&i= funs'kd@;k vfrfjDr@la;qDr ;k mifuns'kd
percentage physical impairment/disability has been muds Vhe ds }kjk mDr izfr;ksfxrk@VwukZesUV esa ------------------------- MkbjsDVªsV vkWQ ifCyd bUlVªD'kUl@f'k{kk -------------------- }kjk
evaluated as per guidelines (......number and date of issue LFkku izkIr fd;k x;kA
of the guidelines to be specified) and is shown against the O;fDrxr :i ls gLrk{kj gksus ij ekU; gksxkA
;g izek.k&i= jk"Vªh; QsMjs'ku@jk"Vªh; ,lksfl,'ku@¼;gk¡ laLFkk
relevant disability in the table below:-
dk uke fn;k tk;s½ --------- esa miyC/k fjdkMZ ds vk/kkj ij fn;k x;k
Permanent gSA APPENDIX-2
S.
Affected physical
Diagno impairment/ LFkku -------------------------- gLrk{kj -------------------------------------- Plan of Examination and Syllabus for the selection of
Disability
part of
sis mental disability
fnuakd ----------------------- uke --------------------------------------------- the post Computer Assistant
N. body
(in%) in ----------------------------------------------- The aforesaid examination shall be conducted in two
laLFkk dk uke --------------------------- phases. There shall be one question paper in first phase,
1. Locomotor disability @
eqgj -------------------------------------------- written examination which will be objective type and
2. Muscular Dystrophy multiple choice. Time period of question paper shall be 01
uksV % ;g izek.k&i= us'kuy QsMjs'ku@us'kuy ,lksfl,'ku ds
3. Leprosy cured hour 30 minutes. There shall be total 100 question in
lfpo }kjk O;fDrxr :i ls fd;s x;s gLrk{kj gksus ij gh ekU;
4. Cerebral Palsy question paper of 100 marks. Each question carrying equal
5. Acid attack Victim
gksxkA marks. On the basis of above said examination 10 times of
6. Low Vision # izk:i & 2 candidates of total Vacant posts shall qualify for Hindi
¼ekU;rk izkIr ØhM+k@[ksy esa vius izns'k dh vksj ls typing (on computer) test on merit basis.
7. Deaf £ In the second phase there shall be hindi typing test on
jk"Vªh; izfr;ksfxrk esa Hkkx ysus okys f[kykM+h ds fy;s½
8. Hard of Hearing £ computer which will be qualifying in nature. Time period of
lEcfU/kr [ksy dh izns'kh; ,lksfl,'ku dk uke --------------- hindi typing test will be 05 minutes. The minimum essential
9. Speech and jkT; ljdkj dh lsokvksa@inksa ij fu;qfDr ds fy, dq'ky required speed of Hindi typing test is 25 w.p.m. Only such
Language disability
f[kykfM+;ksa ds fy, izek.k&i= candidates shall be considered for selection who gets
10. Intellectual Disability
izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ---------------- vkRet@ minimum speed in hindi typing test. Final merit shall be
11. Specific Learning based on marks obtained in only written examination.
Disability
iRuh@vkRetk Jh ----------------------- fuoklh ¼iwjk irk½ -----------------------us
12. Autism Spectrum
fnuka d ----------------ls fnuka d -------------------rd-------------------es a Plan of Examination
¼ØhM+k@[ksy&dwn dk uke½ dh izfr;ksfxrk ¼VwukZesUV LFkku dk uke½--
Disorder S. Part/Subject No. of Marks Time
13. Mental illness ------------------vk;ksftr jk"Vªh;--------------- esa ¼ØhM+k@[ksy&dwn dk uke½ No. Questions Period
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