Form No.
PL:6(OM)
Address while on Leave
60009
SUDIPTA KUMAR GIRI
LEAVE APPLICATION
C/o Village Pin Code
Empl . Code Dept./Sec.Code
DESIGN Dept./Sec. Name
Name Designation
1620, MADURDAHA
DY. MANAGER
ASWINI KR. GIRI
Steel Plantech Engg. India Pvt. Ltd. KOLKATA - 700 156
Father's / Husband's Name FOR URGENT WORK Reason of Leave Leave applied for
700 107
Nature (Leave) Casual Sick Privilege
Days
Form date
To date
Leave due
Leave granted W / Pay W /o Pay
Telegraph Office
20.11.13 28.11.13
Date Recommended / rejected due to Sig./T.I. of Application Sanctioned/Reected due to
Date
Time Keeper
Est. Asst.
Date
Section I/C
Date
Head of Deptt.
Sig./T.I. of Applicant
Name: SUDIPTA KUMAR GIRI Designation: DY. MANAGER Empl Code: 60009 Dept / Quarry Code: DESIGN has been granted / not granted leave for TWO days from 20.11.13 & 28.11.13 with pay / without pay. He must report for duty on.at.....A.M. / P.M. failing which disciplinary action may be taken. Leave refused due to....... LEAVE ORDER NO. Name Empl. Code Date. Designation Dept. Sec. Name Dept. Sec. Code
Form No. PL:6(OM)
LEAVE APPLICATION
Address while on Leave Leave granted W / Pay W /o Pay Section I/C C/o Village Pin Code
Empl . Code
Name Designation Father's / Husband's Name
Steel Plantech Engg. India Pvt. Ltd. KOLKATA - 700 156
Dept./Sec.Code Dept./Sec. Name
Reason of Leave Leave applied for Nature (Leave) Casual Sick Privilege Days Form date To date
Telegraph Office
Leave due
Date Recommended / rejected due to
Sig./T.I. of Application Sanctioned/Reected due to
Date
Time Keeper
Est. Asst.
Date
Date
Head of Deptt.
Sig./T.I. of Applicant
Name........Designation....Empl Code..Dept / Quarry Code.... has been granted / not granted leave for ........days from...to.with pay / without pay. He must report for duty on.at.....A.M. / P.M. failing which disciplinary action may be taken. Leave refused due to....... LEAVE ORDER NO. Name Empl. Code Date. Designation Dept. Sec. Name Dept. Sec. Code
, MADURDAHA
Post Office Dist.
24 Pgs. South West Bengal
State
Leave recommended for ...days
Date
Medical Officer Leave order reveived
Head of Deptt.
Sig./T.I. of Applicant
y Code: DESIGN
disciplinary action may be taken.
Head of Dept./Manager Received your leave applicaiton Dated________________ Date ________ T.K. / Est. Asst.
Post Office Dist.
State
Leave recommended for ...days
Date
Medical Officer Leave order reveived
Head of Deptt.
Sig./T.I. of Applicant
Dept / Quarry Code.... .with pay / without pay. disciplinary action may be taken.
Head of Dept./Manager Received your leave applicaiton Dated________________ Date ________ T.K. / Est. Asst.