APPLICATION FOR LEAVE
1.Name of applicant: KAKALI GHOSH Leave application no:202409089804999
2. HRMS ID: 1994001670
3. Post Held: Health Assistant (Female)
4.Leave Department: Leave Other
5.Parent Department: Health & Family Welfare
6.Present Department: Health & Family Welfare
7.Employment Type: Permanent
8.Employee Type: Employed
9.Leave Rules applicable: G.O. No. 1364-F(P) Dt. 15.02.2012
10. House allowances, conveyance 7056 0 405
allowance, or other Compensatory
allowances drawn in the present post:
11. Nature and period of leave applied for 1.Name of leave:Child Care Leave
and date from which required: 2.Period of leave from:24/09/2024 to 08/10/2024
3.Prefix from:NA to:NA
4.Suffix from:NA to:NA
12.Purpose of leave: Examination of child/children
13.Ground on which leave is applied for: Examination
14.Documents submitted (if any): Date of birth proof of child/children
Schedule of examination of child/children
15.Date of return from last leave, and the 11/04/2024,Earned Leave,27/03/2024 To 10/04/2024
nature and Period of that leave:
16.Are you leaving station: No
17.If yes, then period of station leave:
18.Address for communication during
station leave:
19.Contact no. during station leave:
20.Declaration/undertaking (if any):
Dated Signature of Applicant
21.Remarks and/ or recommendation of
the Controlling officer:-
Dated Signature
Dated Signature
If the applicant is drawing any compensatory allowance,the Sanctioning Authority should state whether on the expiry of leave
he is likely to return to the same post or to another post carrying similar allowance.
