APPUCANON FOR LEAVE
l.Name ol applicant DR SOIITITIRT}IA DAS Leat,€ appf,cation no:Z)2501192188109
2. HRMS ID: 2016flX2530
3. Pcl Held: Bbck fr€dcal Officor d Hoalth
4.kar/6 D€pgrtrlGnt Loa.E0|h0r
s.P8rcnt Dearhont Hedtr e Fadly W€lfar€
6.Pr€3ent Dspartmqlt Hed$ & Fanily W€fate
T.Emplq/rn€nt TlDo:
S.Empbyre Type:
9.lrew Rules appilcabb: Rub
10. Housa alolmnaes, 0 zx)
alhvanca, or dlor
dlowancgs darvn in tho
11. Naturo and pe.bd ol le8\,e d
and .Q6 fiofir
e2ffi1tz{25
't2.Purpo6o ol
13.Ground o.r
l4.Dooments $.6rnittsd (ff sny):
1 s.Dala d r€tum ,rorn la$ leave, and tle fi lOfi nzs.,Ea,ned LeE,vo,Ol n1 EOi To 1 0lO1 I?g25
nalue a,rd P.Ibd ot that lee\r6:
18.fus you leeviu sabo: Yes
l7.lf yeo, then pedod ol st ion l6ew: Frc'fll:,oft1fi 2@'f o24l1fi 2fJ25
'l 8.Addr€ss b
co.nmunicarill drrdng 42/1G PGH SHAH ROAD, KOLKATA 7qXB2
308lirn lmB:
lg.Cootact m. during sratin leave: 95CXt0g6{4
2o.Dedaraion/intkAling G ary):
DaEd tt[]f Signature of Applicar*
21.R€ftErk3ard oI r€coilnendalim c,
tlo contosng otrcec-
Dabd Sgnaturc
AS€IISTA}IT CHIEF MEDICAL OFFICER
OFHEALfi
OaEd Signd,]e
I fl6 €PpIcant is *awing any comp€lrs&ry alotf,ancs,frle Sanctidtng Authority shor{d siEE whefior on th€ wlfuy d l€avr
ho b llkoly to tdum b fio sane pd or !o arlother posi canytB sirrfai anoranri.
To
The AS${llfA}IT O{]EF UEDrcAL OFFICER OF HEALTH
ACrrcH, XALnmOiG
[email protected] ArrUHo4fa, XitTaro. Olt{Iqr^rfs0.:lctnpdtg
P-O.r(.IoIaE, PAjK*lpong, D* r nFngr g**lb.rEilgd, Fh7!t{$l
Go,tffiuto'tV.{Bmed,
$5: -.,olrang R.poil dtar 8lrafrg l€svs
*nAOcn,
I,DR SOI{NRTH,A ldr orn Ahli*dr,6 Soryi tFl&r0 podd Elodr lledtd Otrcer ot
brtncn dtr tErfirg rvalod
I \a(
YaIs'ha!friy,
DRSOilNFTHA DAS,Wd
Eorryd Prdo Hosfh crrrt
Affirr.Sillrl,Bod(
taodcdOltlcerol Hdr
APPLICATION FOR LEAVE
l.Nameof applicant DR SOMTIRTHA DAS Leave application rn:20250126294961 7
2. HRMS lD: 20t60o2ss0
3. Post Held: Bloc* Medical Officer of Heafth
4.Leave Department Leave Other
S.Parent Department Heahh & Family Welfare
G.Present Department l.lealh & Family Welfare
T.Emplopnent TlDe: Permanent
S.Employee Type: Emfloyed
g.Leave Rules applituble: Rute 207 of WBSR-I
10. House alk wares. oonveyan@ 6936 0 200
allowance, or dher CompensaOry
allowances drawn in the presant post:
11. Nature and perkld ol leave applied for l.Name ol leave:Casual Leave
and date from which rcquircd: 2.Pedod d have hqn:27t'O112025to 2910112025
3.Prefixfrom:NA to:NA
4.Suflix from:ltlA to:NA
l2.Purpose ol leave: O$er
13.Ground on ufiich leave is ap$ied for: To attend NEET PG 2024 counselllng
l4.Documents submitted (if any):
l5.Date d return from last leave, and the
nature and Period ol that leave:
16.Are you leaving stratirn: Yes
17.1f yes, then period of station leave: F r om:26 lO1 120125 T o:29/l O1 12O25
1 S.Address for communication during 4A1G PGH SHAH Road, KOLKATA 700oi32
slation leave:
lg.Contact rlo. during station leave: 9593309&44
S.Declaratbrlurdertaking (if any):
Dated
ul"("r Signature ot Applbant
2l.Remarks amU or recommendation of
$e Controlling dfrcer:-
Dated Signature
ASSISTANT CHIEF MEDICAL OFFICER
OF HEALTH
Dated Signature
lf the applicant is drawing any compensatory allowanoe,the Sanctioning Auttnrity shotrld state whetter on the expiry of leave
he is likely to relurn to the same pGt or to anofier post carrying similar allowance.
APPLICATION FOR LEAVE
1.Name applicanr
d DR SOMTIRTHA DAS Leave appliation rrc'.202fi'1ffi7787 17
2. HRMS lD: 2016m2$0
3. Posl Held: Bbck Modical Orficer d Healtl
4.LeaY€ Departrnent: Leave O[pr
S.Parem D€pertn€nt l-lerdth & Farnily Weltare
6.Pr6sent Department l-bdth & Faniry Weltare
T.Emdoymenl Type: Psnvment
S.EmployoeTypo: Emdoy€d
g.Leav€ Rubs apdicabl€: Rule 207 of WBSR-I
10. Hor.Lse allolEnces, @nveyance 6936 0 200
alloryanca, or othgr Compgrsatory
allo rances drawn in the pr6e
post:
11. NeturB ard pedod ol l€ew appliod fror l.Namo ol leave:Cssugl l-6avr
and dat6 lrom whici tEquired: 2.Peri$ d baro trorn:300l/2025 to 31n1nO2S
3.Pr€fix fro.n:NA to:NA
4.Suflix ,rom:tlA b:NA
l2.Purposo ol l6ave: Privaie Aftairs
l3.Ground on which loave is appliod ,or: NEET PG 202a Couneelllp
l4.Documents submitted (if any):
ls.Date of retum from last leave, and the 3cV01 /2025,Casual Loav a,Z7 I O1 DA25 T o 29 01 I 2t25
neturo end Perird ol lhat leave:
'16.Are you leaving station: Yes
17.1, y€s, thon peri()d o, station leave: FEm:30I0t 12025 To31 n1 12025
'l S.Address for communication during 4ZIG PGH SI'IAH ROAD, KOLKATA 7OOO32
sialion learre:
lg.Contad m. during siatbn leave: s5*,309644
20.DeclarationA.ndenaking ff any):
Dared e.{l plt 'tu,,- Signature d Applicant
"r- l'.
21.R€marks and or r€commendation of
the Conlrolling otticer-
Dated Signature
ASSISTANT CHIEF MEDICAL OFFICER
OF HEALTH
Dated Signaturc
ll the.applacant is drawing any corperBatory a[olvance,he Sanctioning Authodty shodd state whethe] on the exdry o, l€ave
ho is lik€ly to rotum to lhg same pct or to anoth€r post Etrrying sir hi elorando.
APPLICATION FOR TEAVE
l.Narn€ of mlioant: OR SOMTIRTHA DAS Loa\re applbalbn mi 20250zsn,,1 gn
2. HRMS ID: 2fiAXrils:X)
3. Poet Held: Blod( t/bdical Olfrce. oa tloaffi
4.1,.€aY9 D€partnont: LsroO0lef
5.P81sm Departiont l-halh & Fsnily Wolraro
6.Prr8or[ DepertmdlE l-lodlh & Farniv W€ltar€
T.Erphymonl Type:
E.Employoo Tpe:
2{X)
b 16/02r202s
!4.Doq/rErB srrbmitted (if any):
,s.OEt€ ol rBtum flun bst baw, and fie
net reand Perlod ol thet leevs:
@lOi2l2@6,E d Lf€|to,UtOZlTb To OTM,EU6
!E.Ar6 l,ou l6avino sEtion: Y€s
t7.f )ras, lh6n pcrlod of ttaton lcsr,€: From: 1 s&12{Xl5 To i1 &ozmas
lS,Arldrers b ommwicadon thrlrg /I2|/IG PGH SHAH ROAD, KoLKATA 70@32
station bave:
lg.contact no. during dadon la,o: 95*lito9644
2o.DedaratiorvundenaHng (tf ay):
Dabd q\{ Slgnrttrr€ o{ Appflcant
2l,Rem 1(8 d/ o rcotrmonffion d
the Co(xroilru dfcoc-
Dst d
Slgnaturc
ASSISTANT CHIEF MEDICAL OFFICER
OFHEALTH
o8Ed
SiignaUrB
IiE,ffiflfrfl?ffi :31,ffi$H,flffiH'f,ffffifjffig1* s're wh6$er on rB e,ary d bevs
To
rTp ASISXA$T 6H{EF.MEDICAL OFFICER OF HEALTI{
ACilOt{, t(ALhlFoilB
l,"qrq.y.&d, U.fior HoSiH, lwnprre, ryfqn^n[bgct(.tmpan
F.O.treS$! P.6-f(&ore, U*.: K*npnol, 8*:UtoO acrqht, FirritOt
Cnlru-nmem0f Wi*8mgd,
$,t: - Jott'ng BWt after svailng lqro
S*etrOarrf
lbafh eun Adnhirhthr-Scwi Iroldng pct tf Elsdr tdodiod O{Rcsr c,
bsd( to my &fu q 17frfr2f,M25 tunnoon afbr fra,lip avathd
t. Eanod L*re to lEOA2(re
@Frurf.S, Frun of /t da!/s.
t
be
Youc: hfffiily,
DR SqfnRTFlA DAS,lAlost
Bsrpnl Pubfic Flg#r qm
AdrfrrlffioS,[Blod(
Medical Oilloerot FbSr
