APPLICATION FOR LEAVE
1.Name of applicant: SHUBHRA BAGCHI Leave application no:202411036235131
2. HRMS ID: 2023016841
3. Post Held: STAFF NURSE
4.Leave Department: Leave Other
5.Parent Department: Health & Family Welfare
6.Present Department: Health & Family Welfare
7.Employment Type: Temporary
8.Employee Type: Employed
9.Leave Rules applicable: Rule 169 of WBSR-I
10. House allowances, conveyance 3684 0 260
allowance, or other Compensatory
allowances drawn in the present post:
11. Nature and period of leave applied for 1.Name of leave:Earned Leave
and date from which required: 2.Period of leave from:16/11/2024 to 05/12/2024
3.Prefix from:15/11/2024 to:15/11/2024
4.Suffix from:NA to:NA
12.Purpose of leave: Private Affairs
13.Ground on which leave is applied for: For My Marriage purpose
14.Documents submitted (if any):
15.Date of return from last leave, and the
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.