All India Institute of Medical Sciences, Gorakhpur
OFFICE ORDER ON APPLICATION FOR LEAVE
#AIIMS GKP/2020/__________/__________
Employee Code No:
Name of the Applicant/Gender:
Post Held & Date of Appointment
Department Office & Section
Basic Pay/Pay Level
Nature and period of leave applied for and date from which required Total Total Reqd No Bal
Leave Availed of Days Leave
Academic Leave with Financial/Without Financial
(CME/Workshop/Conference/Course/Training/Congress/Exam Duty
Casual Leave/RH
Duty Leave
Earned Leave
Half Pay Leave on Medical Grounds
Paternity / Maternity Leave
Compensatory Leave
Dates for which Comp off is Claimed:
_________-__________-2020, _________-________-2020
Sunday and Holidays, if any, proposed to be Prefixed/Midfixed/Suffixed to
leave
Purpose of Leave
Date of return from last leave & nature and period of that leave
I propose/do not propose to avail myself of LTC for block years...............
During ensuring leave
Leave Station
Leaving State
Address during leave period & Mobile No:
Email ID:
Name and Signature of the Reliever
Academic
Clinic
Administrative
TICKET BOOKING REQUISITION (IF FINANCIAL ASSISTANCE) – NA for 2020 & 2021
Travel Date Originating Place Destination Place Flight No. Departure Date & Arrival Date & Time
Train/Car* Time
*(Places connected by train sanctioned under SR- 31)
Signature of the Applicant ( with date) Remarks /Recommendation of HOD
Recommended / Approved / Not Approved Approved / Not Approved
Copy to: HOD/AO/Concerned Faculty/ Guard File.
Note: -
• All Government servants are entitled to 8 CL is in a Calendar Year.
• All Government servants are entitled to 2 RH in a Calendar Year.
• All Government servants are entitled to 20 days of HPL for every completed year of service.
• All Government servants are entitled to 30 EL in a Calendar Year, vacation department 5 and 5 per year for new faculty (1st
year).
• EL cannot be clubbed with CL and its vice-versa.
• All Government servants are entitled for 15 days Paternity Leave for two surviving child.
• All female government are entitled for 180 days Maternity Leave for two surviving child.
• All female government servants are entitled for 730 days CCL Leave for two surviving child leave in their entire service
period (In 3 Spells only).
HOD/Incharge DMS /Incharge Academic A.O. Exe. Director