Ministry of External Affairs
(Haj Division)
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TN38559615
Prescribed application form for temporary deputation to Consulate General of India (CGI) Jeddah, Saudi Arabia in
the indian administrative/medical mission
.
for haj-2015
.Applications should be sent through proper channel
along with the required certificate duly signed. Applications sent directly or without the certificate from the Cadre
Controlling Authority will not be considered.
A. Personal Particulars:
Name of Applicant:
Category:
Mrs. Mannan Ruvetha Begum
Pharmacist
Date of Birth:
Gender:
File Number: TN38559615
16-02-1967 (Age as on 01/07/2015 is 48yrs,137Days )
Female
Father Name:
Previous Haj Details:
M G Abdul Mannan
1999,2003,2005,2008,2011,2014
B. Job Related Particulars:
Govt. Servant:
Yes
Gazetted:
No
Permanent in Govt. Service:
Yes
Date of Joining Govt. Service:
22-07-1988 (Exp. as on 01/07/2015 is 26yrs,344Days )
Applicant Post/Designation:
Grade Pay:
Pharmacist/Pharmacist
4600
Pay Scale:
Staying in Govt. accomodation:
9300-34800
NO
Exp. as Medical Officer in months(In case of Doctor):
Is Allopathic(In case of Doctor):
C. Applicant Qualification/Skill Details:
Qualification:
Specialization:
Pharmacist
PHARMACIST
Knowledge of Arabic:
Mother Tongue:
No
Hindi/urdu
Regional Language 1:
Regional Language 2:
Tamil
Hindi/urdu
D. Applicant Office/Present Details:
Office address:
Chengalpattu Medical College Hospital, Chengalpattu 603001,Kanchipuram,Tamil Nadu,603001
Office Phone:
Mobile No.:
NIL
+919444660786
Email Address:
Fax Nos:
shameera.roohin@gmail.com
NIL
Present Address:
17c, Varadhanar Street, Vedhachalam Nagar. Chengapattu,Kanchipuram,Tamil Nadu,603001
E. Cadre Authority Details:
Cadre Auth. Name:
Jaya Govindarajan
Cadre Auth. Address:
Chengalpattu Medical College Hospital, Chengalpattu 603001,Kanchipuram,Tamil Nadu,603001
F. Uploaded Documents Details:
1. Applicant Image 2. Diploma In Pharmacist 3. Pharmacist Registration Certificate 4. Sslc Certficate 5. Fitness
Certificate
Certificate:
a.
I hereby certify that the information given above is complete and true. I have carefully read the terms & conditions and
undertake to abide by them during my deputation to Consulate General of India, Jeddah (Saudi Arabia).
b. I also certify that I do not suffer from any serious heart ailment, hypertension, diabetes and asthma or kidney .If information
provided by me is found to be false at any stage ,Govt. of India can recover full or partial amount spent on me.
c. I undertake that I shall not accept any remuneration from pilgrims for service render to them.
d. I also undertake that during the period of deputation, I shall not perform Haj pilgrimage.
Date: .
.
Applicants signature
Caution:
a)
Any information regarding number of earlier deputations and Date of Birth suppressed or falsely given will render
the applicant liable to disciplinary action besides rejection of his/her application.
b) Incomplete application is liable to be rejected
c)
The applicant shall be liable to disciplinary action under the relevant provisions of CCS (CCA)/Conduct Rules if
information in Col.4 to 10 is found incorrect.
d) Necessary entries regarding deputation should be made in service book of the concerned official.
e)
Attention of applicants is also invited toward Clause 20 of the CSS(Conduct Rules),1964 which say, No
Government servant shall bring to attempt to bring any political or other outside influence to bear upon any
superior authority to further his interests in respect of matters pertaining to his service under
Government. Ministry may initiate disciplinary action against applicants who violated the abovementioned clause.
(Enclosure to Printed Application form)
CERIFICATE TO BE FURNISED BY THE CADRE CONTROLLING AUTHORITY IN THE
PRESCRIBED FORMAT(IN BLOCK LETTERS)
Mrs. Mannan Ruvetha Begum
Certified that as per entries made in the service book of .
,his/her
Pharmacist/Pharmacist
present designation is..............and his/her date of birth is
16-02-1967 (Age as on 01/07/2015 is 48yrs,137Days ) .He/She joined the Government Service
.........................................................
22-07-1988 (Exp. as on 01/07/2015 is 26yrs,344Days ) .He/She is a ..................................................
Permanent Non Gazetted
on ...............................
9300-34800
officer
in
the
pay
band
Rs..&
Grade
pay
of
4600
Rs....and
has
been
on
deputation
to
Saudi
(1) 1999 (2) 2003 (3) 2005 (4) 2008 (5) 2011 (6)He/She
2014
Arabia....................................................................................
is eligible for short term
deputation as coordinator, Assistant Haj Officer/Haj Assistant/Doctor/Nurse/Pharmacist/Lab Technician/
X-RayTechnician/ECG Technician(Tick the appropriate) to Consulate General of India, Jeddah. No
disciplinary action is pending against him/her.
*( Cadre controlling Authority MUST mention equivalent pay band of the candidate at par with the six
pay commission of central government employees.)
Mrs. Mannan Ruvetha Begum .. is also well versed/ inept(Tick the appropriate)
And it is also certified that
in computer.
Signature
Name and Designation with seal..
Jaya Govindarajan
..
Telephone No. (With STD code).
Telephone No. (With STD code).
Mobile No..
E-mail Address.
(The controlling authority will be held responsible if the information furnished is found incorrect.)
