To
The Principal,
SMS Medical College,
Jaipur.
Subject :- Option for NPA.
Sir,
I, Dr. __________________ hereby option to draw
Non-Practicing Allowance and shall not undertake any
private practice and charge professional fee during the year
2024.
Place:-
Date:- (Signature)
Name of Doctor:- ________________
Designation:-________________
Department:- ________________
To,
The Principal & Controller,
SMS Medical College,
Jaipur.
Through Proper Channel
Subject: - For Non Practicing Certificate
Respected Sir,
I Dr._________________________Surgery is submitting my Non Practicing
Monthly Certificate for the______________- 2025. I hereby also declare
that I will not undertake any private practice and charge professional fee for
the above mentioned month.
Kindly accept.
Encl: -
01. Certificate
Yours Sincerely
(Dr. )
Professor/ Assoc. Prof. / Asstt. Prof. Surgery.
SMS Medical College, Jaipur.
CERTIFICATE
It is certified that no Private Practice was undertaken by me and no
professional fees was received during month of _____________-2025 for
which non practicing / non clinical allowance is admissible to me.
Place: Signature
Date: Designation
GOVERNMENT OF RAJASTHAN
FORM OF APPLICATION FOR LEAVE UNDER
THE RAJASTHAN SERVICE RULES
1. Name of applicant and father’s/ husband’s name –
2. Post held -
3. Department, office and section-
4. House rent allowance, conveyance allowance or other compensatory al-
lowance drawn on the present post:-
5. Nature and period of leave applied -
for and date from which required
6. Sundays and holidays, if any, proposed to be prefixed/ suffixed to leave -
7. Ground on which leave is applied for-
8. Date of return from last leave and the nature and period of that leave-
9. (a) I undertake to refund the difference between the leave salary drawn dur-
ing privilege leave/ commuted leave and date admissible during half – pay leave
which would not have rule (2) of Rajasthan Service rules not been applied in the
event of my retirement from service at the end or during the current of the leave-
(b) I undertake to refund the leave salary drawn during “leave not due”-
Which would not have been admissible had rule 93 (d) of the Rajasthan Service
Rules not been applied, in the event of my voluntary retirement from service at
the end or during the current of the leave.-
10. Leave Address -
Signature of applicant (with
Date)
11. Remarks and / or recommendation of the controlling officer.
Signature (with Date)
Designation
OPTION
I __________________________hereby opt to draw Non-
Practising Allowance and shall not undertake any private
practice and charge professional fee during the year
__________20_______.
Place: Signature
Date: Designation
CERTIFICATE
It is certified that no Private Practice was undertaken by me and no
professional fees was received during month of _____________________
for which non practicing / non clinical allowance is admissible to me.
Place: Signature
Date: Designation
CERTIFICATE
It is certified that no Private Practice was undertaken by me and no
professional fees was received during month of _____________________
for which non practicing / non clinical allowance is admissible to me.
Place: Signature
Date: Designation
To,
The Principal & Controller,
SMS Medical College,
Jaipur.
Through Proper Channel
Subject: - For Non Practicing Certificate
TO,
THE PRINCIPAL
J.L.N. MEDICAL COLLEGE
AJMER.
REFERENCE NO:- F ( ) /MC/EG/2015/ 30878-81 DATED. 17/10/2015.
Respected Sir,
I Dr. Rajendra Bagree, Prof. Surgery is submitting my Non Practicing
Application from the month of Feb- 2016.
Kindly accept.
Encl: -
01. Certificate
Yours Sincerely
(Dr. Rajendra Bagree)
Prof. Surgery
Department of surgery
To,
The Principal & Controller,
SMS Hospital & Medical College,
Jaipur.
Through Proper Channel
Subject: - For Reimbursement of Telephone Bill.
Respected Sir,
Dr. Laxmi Narayan Meena, Assoc. Prof. surgery submitting my telephone
bill of_________________month.
Thanking you.
(Dr. Laxmi Narayan Meena)
Assoc. Prof. Surgery
Enclosure: -
1. Telephone bill.
2. Receipt
To,
The Principal & Controller,
SMS Medical College,
Jaipur.
Through Proper Channel
Subject: - For Non Practicing Certificate
Respected Sir,
I Dr._________________________Surgery is submitting my Non Practicing
Monthly Certificate for the______________- 2019. I hereby also declare
that I will not undertake any private practice and charge professional fee for
the above mentioned month.
Kindly accept.
Encl: -
01. Certificate
Yours Sincerely
(Dr. )
Prof. Surgery
SMS Medical College, Jaipur.
.
DEPARTMENT OF SURGERY
SMS MEDICAL COLLEGE & HOSPITAL JAIPUR.
NO. MC/SURG/2018 DT.
To,
The Principal & Controller,
SMS Medical College,
Jaipur.
Through Proper Channel
Subject: - Cancellation of N.P.A.
Sir,
I Dr. Rajendra Bagree, Professor , Department of Surgery is hereby
requesting for the cancellation of N.P.A with effect from Jan. 2019
onwards.
Kindly consider it for the same.
(Dr. Rajendra Bagree )
Professor
Department of surgery
DEPARTMENT OF SURGERY
SMS MEDICAL COLLEGE & HOSPITAL JAIPUR.
NO. MC/SURG/2016 DT.
Dr. Richa Jain
Professor & Unit
Surgical Unit – VI
Department of Surgery
Subject :- Absentee Status of Dr. Kuldeep Poonia (III rd year
resident)
Madam,
This is to know about the absentee status of Dr. Kuldeep Poonia
(III rd year resident ) whether he is on leave or absent please
clarify it and give details to HOD surgery as soon as.
(Dr. R.K.Jenaw)
Prof & Head
Department of Surgery
To,
The Principal & Controller,
SMS Medical College,
Jaipur.
Through Proper Channel
Subject: - For ACR Form (2015 - 2016)
TO,
THE PRINCIPAL
J.L.N. MEDICAL COLLEGE
AJMER.
REFERENCE NO:- F ( ) /MC/EG/2015/ 30878-81 DATED. 17/10/2015.
Respected Sir,
I Dr. Rajendra Bagree, Prof. Surgery is submitting my ACR Form on
12/04/2016.
Kindly accept & forward as per rule.
Yours Sincerely
(Dr. Rajendra Bagree)
Prof. Surgery
Department of surgery
To,
The Principal & Controller,
SMS Medical College,
Jaipur.
Through Proper Channel
Subject: - For Non Practicing Certificate
TO,
THE PRINCIPAL
GOVT.MEDICAL COLLEGE
KOTA.
REFERENCE NO:-
Respected Sir,
I Dr. Richa Jain, Prof. Surgery is submitting my Non Practicing Application
from the month of _______________ 2016.
Kindly accept.
Encl: -
01. Certificate
Yours Sincerely
(Dr. Richa Jain)
Prof. Surgery
Department of surgery
To,
The Principal
SMS Medical College,
Jaipur
Through Proper Channel
Subject :- Allot ment of chamber to Assoc. Prof and Asstt. Prof as per
MCI norms.
Sir,
With due respect we want to stat that as per MCI norms kindly provide
chambers to Assoc. Prof. and Asstt. Prof :-
01. As there is no space for sitting for Assoc. Prof. and Asstt. Prof.
02. There are no facilities for natures call and other daily work.
03. There is no space for doing research work and for keeping file and
research record.
So according to MCI rule. Kindly provide chamber for Assoc. Prof and
Asstt. Prof.
Thanking you.
Assoc. Prof. Asstt. Prof.
(Dr. R.K.Jenaw)
Senior Prof & Head
Department of General Surgery
To
The CMHO,
Bhilwada, Rajasthan
Subject :- Option for NPA.
Sir,
I, Dr. Anuradha Salvi hereby option to draw Non-
Practicing Allowance and shall not undertake any private
practice and charge professional fee during the year 2023.
Date:- (Signature)
Dr. Anuradha Salvi
Medical Officer
Mahila Hospital Sanganeri Gate
Jaipur.
