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Í¡¨â} RÂoÍxt k#¡# ð| ÑÍhz ð|ÂQ Ý$öæz/jöÂzÝz iS /05/2015, ÍÝutÔ fmdaIK yd foaYSh ffjoH ðѨgÔ¨|³Q, Ýe úÝ#_¡¨Q, 385, ¡ècÔ ¹âμ zÍâμ zhÑ ¥Ñkú|³ ï¼l Ѩúg, ͨdÏ 10. 2015.09 . ú© âμ ¼©. ¡d¨gz ÍÝutÔ Íx¬úôA©z, ¡d¨gz ÍÝutÔ ÍÝzú¨ ðHÔÂzÄúôA©z, m%dfoaYsh ¡d¨gz ÍÝutÔ ÍÝzú¨ ðHÔÂzÄúôA©z, ¥ÑHÔhg ͨÁ¤¨³ T¨ô ¡oH¨©$©z, Í[\Q ðѨgÔ¨|³Q QÒgÒ hAÍ©© Ý#Q±Ñ Íô¨zïx ðHÔÂzÄúôA©z ï¨ ð¨Qg© ¡oH¨©$©z Íúg. úMgzg$Q BÂ#gzÝ III fY%aKsfhA ^II mka;sh ’wd¶ LKavh& ks,OdrSka ioyd jk ¨[QÂzÄÑg¨ ¸ª¬ ¥T¨hQ iy fomd¾;fïka;+ mrSlaIKh 2015 úMgzg$Q BÂ#gzÝ III fY%aKsfhA ©#kH¨I©z Ýíμï¨ ú© ¨[QÂzÄÑg¨ ¸ª¬ mrSlaIKh 2015' 10' 31 jk osko fomd¾;fïka;+ mrSlaIKh 2015' 11' 01 ú© âμ ¼©o Ý#|ïk, Íâμ Ñd ï¨ ª|ho$Ý# ѨHÔúk# ©z ¡úgzú©e k¹© ¹ú ÍÑQ#©z ©#Ͷâμ ©Q Âô©e kAÍÜ. úIhdkqnoaO m%Yak m;%h bx.%Sis udOHfhka muKla meje;afõ' ¥T¨hQ ¡úgzú©e k¹© Ýzr¨©Q ï¨ Â¨kÝÒï© ¡oͶ³ ¡goÍQz Ýíμ ï©z Âô©e ðAg. 02. Ýeâ}Ýe¬ - ÍÑÑ ¥T¨hQÒ ðQâ}¬ Âd ïAÂzÍÂz úMgzg#Q BÂ#gzÝ III fY%aKsfha $II ð¨LKavfha ¡gzùÑÂz ,nd we;s iy fuf;la úNd.h iïmQ ¾K lr fkdue;s ©#kH¨I©zÒ ¡Ñ«. 03. ðQâ}¬¡gz - ÍÑÑ RÂoÍxtÍQz ðhÒ âμ Âzú¨ ðAg# ð¨ÂMg#Q ð©eú ðQâ}¬ÂôAú©z ¥Ý#©z ÝÂÝz Âôhg Qeg¿ ðQâ}¬¡gz ð¨Qg© ¡oH¨©#Q¨ Ñh#©z, ͨdÏ 10, ¡ecÔ ¹âμ zÍâμzhÑ ¥Ñkú|³ ï¼l Ѩúg, ð| 385, ÝeúÝ#_¡¨Q Íh¨¸©Ah#xÍx ðHÔÂzÄ (¥T¨h) Íúg 2015'10'15 âμ ¼© Íï¨z jÒ Í¡ô kA͹© ÍÝz Íxt©hg gA¡DÍk©z ö¥Q Qeg¿Q. ÝDÑ ðQâ}¬¡gÂÑ âμ Âzú¨ ðAg# Íg¨ôg¿ôA ©#úAôâμ ¼ ¹ú ͨÁ¤¨³ ¡oH¨©#Q¨ ¥Ý#©z Ýïg# Âô g#FQ Qeg¿Q. gÑ ðQâ}¬¡g ÝÑá k#¡#©Q k#Q© kâμ ( ÍÑï¼ ô¨c¨_ k#¡#©Q Íï¨z Í¡uâμzhk# k#¡#©Q k#¥Q ïAÂ#Q. ) ôA.35.00 Âz úש¨ Ñeâμ zâμ ô ðAkúe 9”X4¡oѨÈÍQz k#Qe¬ Âúô 02 âμ ö¥Q Qeg¿Q. ¡oѨâμ ù kA͹© , ðݬ¡è[È Íï¨z úAôâμ ¼ Ýï¼g ðQâ}¬¡gz ¡og#ÂzÍÄz¡ Âô©e kAÍÜ. ie'hq' ( wdor®Y wh¥ïmf;ys wdlD;shg wkqj, wh¥ïm;%h A 4 lvodishl m<uq msgqfõ wxl 1 isg 4 olajd;a fojk msgqfõ wxl 5 isg 9 olajd;a ilia l< hq;=h' by; wdlD;shg wkql+, fkdjk ishÆu wh¥ïm;% kej; oekqï oSulska f;drj m%;slafIam lrkq ,efí' 04. ¥T¨h h¨Ýzg¿ I. ¥T¨hQÒ ¡dÑeú© úg¨úÒ ªâμ¼_¡gz ú© ðQâ}¬ÂôAú©z ¥T¨h h¨Ýzg¿úk#©z ©#âμ ïÝz Âô©e kAÍÜ. ðͩ¿gz ðQâ}¬ÂôAú©z öÂz ¥ÄQÂÒ ôA. 25/- ¹Ah#©z ðúk|h¿ Í©¨Âk Ñeâμ zâμô ªx±¬ ¡goÍQz ðkú¨ gÑ©zÍhz ðgzÝ© ï¨ âμ ¼©Q ÍQ¨âμ ¨ öLú¨ ©#Ý# ÍkÝ ðúk|h¿ Âd Qeg¿Q. II. Â#Ý#â} ÂôAÈÂz Ñg ÍÑÍÝz Íhú© kâμ ¥T¨h h¨Ýzg¿ Íú©gz ¥T¨hQÂz Ýíμ ï¨ Ñ¨ôA Â#IÑÂz Íï¨z ð¨¡Ýe ÍhùÑÂz Ý#â}Âô©e Í©¨kAÍÜ.

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Í¡¨â} RÂoÍxt k#¡# ð|Â

ÑÍhz ð|ÂQ Ý$öæz/jöÂzÝziS/05/2015,

ÍÝutÔ fmdaIK yd foaYSh ffjoH ðѨgÔ¨|³Q,

ÝeúÝ#_¡¨Q,

385, ¡ècÔ ¹âµzÍâµzhÑ ¥Ñkú|³ ï¼l Ѩúg,

ͨdÏ 10.

2015.09 . ú© âµ¼©.

¡d¨gz ÍÝutÔ Íx¬úôA©z,

¡d¨gz ÍÝutÔ ÍÝzú¨ ðHÔÂzÄúôA©z,

m%dfoaYsh ¡d¨gz ÍÝutÔ ÍÝzú¨ ðHÔÂzÄúôA©z,

¥ÑHÔhg ͨÁ¤¨³ T¨ô ¡oH¨©$©z,

Í[\Q ðѨgÔ¨|³Q QÒgÒ hAÍ©©

Ý#Q±Ñ Íô¨zïx ðHÔÂzÄúôA©z ï¨

ð¨Qg© ¡oH¨©$©z Íúg.

úMgzg$Q BÂ#gzÝÂ III fY%aKsfhA ^II mka;sh ’wd¶ LKavh& ks,OdrSka ioyd jk

¨[QÂzÄÑg¨ ¸ª¬ ¥T¨hQ iy fomd¾;fïka;+ mrSlaIKh – 2015

úMgzg$Q BÂ#gzÝ III fY%aKsfhA ©#kH¨I©z Ýíµï¨ ú© ¨[QÂzÄÑg¨ ¸ª¬ mrSlaIKh 2015' 10' 31 jk osko

fomd¾;fïka;+ mrSlaIKh 2015' 11' 01 ú© âµ¼©o Ý#|ïk, ÍâµÑd ï¨ ª|ho$Ý# ѨHÔúk#©z ¡úgzú©e k¹© ¹ú ÍÑQ#©z

©#Ͷ⵩Q Âô©e kAÍÜ. úIhdkqnoaO m%Yak m;%h bx.%Sis udOHfhka muKla meje;afõ' ¥T¨hQ ¡úgzú©e k¹© Ýzr¨©Q

ï¨ Â¨kÝÒï© ¡oͶ³ ¡goÍQz Ýíµï©z Âô©e ðAg.

02. Ýeâ}Ýe¬ - ÍÑÑ ¥T¨hQÒ ðQâ}¬ Âd ïAÂzÍÂz úMgzg#Q BÂ#gzÝ III fY%aKsfha $II “𨔠LKavfha

¡gzùÑÂz ,nd we;s iy fuf;la úNd.h iïmQ¾K lr fkdue;s ©#kH¨I©zÒ ¡Ñ«.

03. ðQâ}¬¡gz - ÍÑÑ RÂoÍxtÍQz ðhÒ âµÂzú¨ ðAg# ð¨ÂMg#Q ð©eú ðQâ}¬ÂôAú©z ¥Ý#©z ÝÂÝz Âôhg Qeg¿

ðQâ}¬¡gz ð¨Qg© ¡oH¨©#Q¨ Ñh#©z, ͨdÏ 10, ¡ecÔ ¹âµzÍâµzhÑ ¥Ñkú|³ ï¼l Ѩúg, ð| 385,

ÝeúÝ#_¡¨Q Íh¨¸©Ah#xÍx ðHÔÂzÄ (¥T¨h) Íúg 2015'10'15 âµ¼© Íï¨z jÒ Í¡ô kA͹© ÍÝz

Íxt©hg gA¡DÍk©z ö¥Q Qeg¿Q. ÝDÑ ðQâ}¬¡gÂÑ âµÂzú¨ ðAg# Íg¨ôg¿ôA ©#úAôâµ¼ ¹ú ͨÁ¤¨³

¡oH¨©#Q¨ ¥Ý#©z Ýïg# Âô g#FQ Qeg¿Q. gÑ ðQâ}¬¡g ÝÑá k#¡#©Q k#Q© kâµ ( ÍÑï¼ ô¨c¨_

k#¡#©Q Íï¨z Í¡uâµzhk# k#¡#©Q k#¥Q ïAÂ#Q. ) ôA.35.00 Âz úש¨ Ñeâµzâµô ðAkúe 9”X4” ¡oѨÈÍQz

k#Qe¬ Âúô 02 âµ ö¥Q Qeg¿Q. ¡oѨⵠù kA͹© , ðݬ¡è[È Íï¨z úAôâµ¼ Ýï¼g ðQâ}¬¡gz ¡oog#ÂzÍÄz¡

Âô©e kAÍÜ.

ie'hq' ( wdor®Y wh¥ïmf;ys wdlD;shg wkqj, wh¥ïm;%h A4 lvodishl m<uq msgqfõ wxl 1 isg

4 olajd;a fojk msgqfõ wxl 5 isg 9 olajd;a ilia l< hq;=h' by; wdlD;shg wkql+,

fkdjk ishÆu wh¥ïm;% kej; oekqï oSulska f;drj m%;slafIam lrkq ,efí'

04. ¥T¨h h¨Ýzg¿

I. ¥T¨hQÒ ¡dÑeú© úg¨úÒ ªâµ¼_¡gz ú© ðQâ}¬ÂôAú©z ¥T¨h h¨Ýzg¿úk#©z ©#âµïÝz Âô©e

kAÍÜ. ðͩ¿gz ðQâ}¬ÂôAú©z öÂz ¥ÄQÂÒ ôA. 25/- ¹Ah#©z ðúk|h¿ Í©¨Âk Ñeâµzâµô ªx±¬

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II. Â#Ý#â} ÂôAÈÂz Ñg ÍÑÍÝz Íhú© kâµ ¥T¨h h¨Ýzg¿ Íú©gz ¥T¨hQÂz Ýíµï¨ ѨôA Â#IÑÂz

Íï¨z ð¨¡Ýe ÍhùÑÂz Ý#â}Âô©e Í©¨kAÍÜ.

05. ¥T¨hQÒ ðAg¿dgz Âô hA©$Ñ.

I. ¡#d#hgz ðQâ}¬¡gz Ýíµï¨ ðÍ¡zÂzÄÂQ©zÒ ¡oͶ³¡gz ©#¿gz Âô©e kAÍÜ. öÑ ¡oͶ³¡gz

©#Qlg ¡_âµ¼ ݬ¡e[È Âô ¥T¨h ³¨k¨÷¡g# Íúg ªâµ¼_¡gz Âd Qeg¿Q. öÍÝz Í©¨ÑAg#ú

¥T¨hQÒ Í¡©$ Ý#^ÑÒ ª¸Í⵩e Í©¨kAÍÜ.

II. ¥T¨h ðÍ¡zÂzÄ / ðÍ¡zÂzÄ#¨ú©z ¥Ý#©z ¥T¨h ³¨k¨ú g¿dâµ] ¥T¨h ³¨k¨÷¡g#Ò ÝzúÂ$Q

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(ð) Pd;sl ïAí}©e¬¡g.

(ð¨) Íⵡ¨[gͬ©zg¿ú Ñh#©z ©#¿gz Âô©e k¹© ïAí}©e¬¡g

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(ðD) j,x.= õfoaY hÑ©z ¹k¡goQ

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fomd¾;fïka;= mrSlaIKh k#sg, ú¨BÂ ï¨ ¡o¨ÍQ¨zh# QAQ# ͨÒÝz g¿©Â#©z ÝÑ©z¥g jk w;r ld¾hlaIu;d

lvbï mrSlaIKh" wdh;k ix.%yh uqo,a fr.=,dis hkqfjka fldgia follska hqla; fõ' öÂz öÂz ͨÒÝÂz

Ýíµï¨ k¿Èe 100 ¹Ah#©z Íú©z ÍÂÍ[. ÝÑgzùÑ Ýíµï¨ öÂz ͨÒÝÂÒ ðúÑ ú³ÍQ©z k¿Èe 40Âz k¹¨hg

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07. ¥T¨h ©#[Íâµz³ Ѩk¨ú

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07.1.1 ldr®hd, mrsmd,kh yd wdh;k ix.%yh ^ld,h meh 02 hs m%Yak 07 lska 04 lg ms<s;=re

iemhsh hq;= w;r iu;ajSu i|yd wju ,l=Kq 40la ,nd.; hq;=h&

¥ÄQ ©#[Íâµz³Q

II jk mrsÑfPaoh ) fiajhg n|jd .ekSfï l%shd mrsmdáh yd m;a lsrSï

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IV jk mrsÑfPaoh ) udia mâ, ;djld,sl ;;ajh, ia:sr;ajh iy úY%du jegqma ysñlu

V jk mrsÑfPaoh ) uqod yerSu" kej; fiajhg .ekSu iy fiajh wjika lsrSu

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XIV jk mrsÑfPaoh ) osjhsk ;=, rdcldrs .uka

XIX jk mrsÑfPaoh ) rcfha ksjdi

XLVII jk mrsÑfPaoh ) idudkH yeisrSu yd úkh

07.1.1 uqo,a fr.=,dis ^ld,h meh 02 hs m%Yak 07 lska 04 lg ms<s;=re iemhsh hq;= w;r iu;ajSu

i|yd wju ,l=Kq 40la ,nd.; hq;=h&

¥ÄQ ©#[Íâµz³Q

I jk mrsÑfPaoh ) úhoï yd wdodhï weia;fïka;= , taldnoaO wruqo,, jdr®Isl

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wkqu; lsrSu iy;sl lsrSu ldr®hh mejrSu.

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ú© ¡|g#ÍQz “𨔠tÞ¸ÍQz úMgzg$Q BÂ#gzÝ ©#dH¨I©zÍhz âµA©hA©$ÑÒ ÝkÝzú©z©. fuu f;dr;=re

www'health'gov'lk fjí wvúfhkao ,nd.; yelsh'

ie hq - úNd. ksfõokfha fou< yd bx.%Sis mßj¾;khka w;r hï jHdl+,;djla u;= jqjfyd;a isxy, udOH úNd.

ksfõokh n, meje;afõ'

tï ì t,a ryqudka

©#ÍQ¨zcÔ ðHÔÂzÄ c©ô¨x (¡¨k© II)

ÍÝutÔ fiajd ðHÔÂzÄ c©ô¨x Íú©eúÒ.

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01. (ð) I. ðQâ}¬ÂôAÍhz ©Ñ ( Ý#|ïÍk©z Ñek¿ôA ðhÒ ÍQ¨âµ̈ k#Q©z© ) - ........................................................................................

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....................................................................................................................................................................................................................................................... IV. Ñek¿ôA úk#©z ïAíµ¼©zÍú© ©¬ (ª|ho$Ý# ÂA¡#Òx ð¿_©z) ­-

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II. ÍÝzúÍQz Ýzr¼ô Âô© kâµ âµ¼©Q ï¨ k#¡# ð|ÂQ - .............................................................................................................

III. âµA©z k¹© ú¨[Ä# úAÒe¡ - ..........................................................................................................................................................

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(b) 1. gA¡Ax k#¡#©Q ( Ý#|ïÍk©z )- ......................................................................................................................................................................................

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05. (ð) qÒ ¡orÑ ÍÑÑ ¥T¨hQÒ Í¡©$ Ý#×ÍQzâµ? ......................................................................................................................................................

(ð¨) ¡orÑ úôÒ Í©¨Í¶ ©¬ Ñeâµzâµô ðkú¨ g#ÍÜâµ? ............................................................................................................................................

06. ðQâ}¬ÂôAÍhz Ýïg#ÂQ

ÑÍhz âµA©eÑ ï¨ ¥³zú¨ÝQ ¡_âµ¼, (I) ÍÑÑ ªx±¬ ¡goÍQz Ýíµï©z Âô ðAg# Íg¨ôg¿ôA ÝgÔ ¹úgz, ÍÑÑ ¥T¨hQÒ Ñ¨ Í¡©$ Ý#שzÍ©z ¡orÑ

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Ñeâµzâµô ͨÒeú,

General Circular Letter No: -

My No. CF/EXC/05/2015

Ministry of Health" Nutritions & Indigenous

Medicine"

"Suwasiripaya"

385, Ven. Baddegama Wimalawansa Thero Mw.

Colombo 10.

.09.2015

Provincial Health Secretaries

Provincial Directors of Health Services

Deputy Provincial Directors of Health Services

Heads of Decentralized Units

Directors of Hospitals under the Line Ministry &

Heads of Institutions

Efficiency Bar Examination and Departmental Examination for Grade III / (II – ’B¶) Occupational Therapists – 2015

It is hereby notified that the Efficiency Bar & Departmental Examination which should be passed before reaching the

fourth salary step of the salary scale approved for Grade III Occupational Therapists Efficiency Bar Examination will

be held on 31.10.2015 & Departmental Examination will be held on 01.11.2015 in Sinhala, Tamil and English

medium. (The Subject related question paper will be prepared only in English Medium.)

The venue and the time of the examination will be notified along with the Admission Card.

02. Qualifications

Officers who have been appointed to the Occupational Therapist Grade III / (II – ’B~) of the Service and

who have not completed the relevant examination as yet can apply for this examination

03. Applications

Applications prepared by the candidates as per specimen appended to this letter should be sent under

Registered cover to reach the Director (Examinations) "Suwasiripaya" No.385, Ven. Baddegama

Wimalawansa Thero Mawatha, Colombo 10, on or before 15.10.2015 through their Heads of Institutions. The

Head of Division should certify the accuracy of contents in each application. 02 self addressed envelope

( Candidates can write their official or private address) in the size of 9" x 4" inches, affixed with stamps to the

value of Rs. 35.00 should be sent along with the application. Applications which are received late , incomplete

or inaccurate will be rejected.

Note : The application should be prepared using an A4 paper based on the specimen form of the

application so as to recommended from 01 to 04 on the first front page and from 05 to 09 on the

second page. Application which do not conform to above will be rejected any information.

04. Examination fees :-

I Candidates who sit the examination for the first time need not pay examination fees. However in

every subsequent sitting they should affix stamps to the value of Rs. 25/= per subject in the stamps

cage provided for in the application and cancel same by placing their signature and the date.

II The fees once paid will not be allowed to transfer for any other Examination or refunded under any

circumstances.

05. Admission to the Examination :-

I Candidates whose applications have been accepted will be issued with Admission Cards. They should

duly complete and submit same to the Supervisor at the Examination centre. Otherwise they will not

be allowed to sit the examination.

II Candidates should prove their identity to the Supervisor at the examination centre. For this purpose

one of the following documents will be accepted.

( a ) National Identity Card

( b ) Departmental Identity Card

( c ) Valid Driving License

( d ) Valid Passport

06. Scheme of the Examination :-

This examination consists of two parts, namely: Departmental Examination & Efficiency Bar

Examination. The Departmental Examination shall have three parts viz: Written, Viva Voce and Practical

test and the Efficiency Bar Examination shall have two parts namely Office Administration &

Establishment Code and Financial Regulations. Marks 100 have been assigned for each part and

candidates should score minimum of 40 marks for each part to secure a pass in the examination. They can

complete the examination in one sitting or in several.

07. Syllabus of the Examination

07.1 Efficiency Bar Examination

1. Office Administration & Establishment Code (This is a separate Essay type Question

paper of 02 hours. Should answer 04 out of 07 Questions Total Marks 100' minimum of

40 marks for pass in the examination.)

Following chapters of the Establishment Code

Chapter 11 Recruitment Procedure and appointments

Chapter 111 Transfers

Chapter 1V Monthly payments, Temporary status, Permanent status and Pension ability

Chapter V Release, Reversion and Termination of Employments

Chapter V111 Overtime, Holydays, Holyday pay and Allowances

Chapter X11 Leave

Chapter X111 Railway warrants

Chapter X1V Travel on duty within the Island

Chapter X1X Government Quarters

Chapter XLV11 General conduct and Discipline

2. Financial Regulations (This is a separate Essay type Question paper of 02 hours.

Should answer 04 out of 07 Questions Total Marks 100' minimum of 40 marks for a

pass in the examination.)

Chapter 1 Expenditure and Revenue Estimates, Consolidated Fund, Annual

Estimates, Alteration of Annual Estimates ( FR from 1 to 68 )

Chapter 111 Financial Management and accountability: - Chief Accounting Officer,

Accounting Official Revenue Account, Authority for payment. Approval

certification assignment (FR from 124 to 147)

07.2 Departmental Examination

Subject related question paper

Duration 03 hours. Should answer 04 questions out of 07 questions in the questions paper.

Total marks 100. minimum of 40 marks for each part to secure a pass in the examination.

Syllabus

i. Treatments for physically desirable. Persons through Occupational Therapy

ii. Treatments for mentally retarded persons and child mental patients through

Occupational Therapy

iii. Communication and Administration

iv. Psychology and Mental therapy

v. Organization of the Occupational Therapy Unit nearly and maintenance and repairs

of the equipment of the unit

07.2 Practical test - A practical test related to the subject field to examine skill and

abilities. Both parts Mental & Physical will include to this test -

Total Marks 100. Time about 60 minutes

07.3 Viva Voce - An oral test on issues that would arise when attending to the

duties in the subject field -Total Marks 100. Time 15 minutes

Please bring the contents of this circular to the notice of all eligible Occupational Therapists

Class II Seg. "B" in your Division/ Specialised Campaign/ Institution. The Information is also

available on the web site – www.health.gov.lk

n.b. – Sinhala medium notification on examination will be effected if any contradictory is

arisen in the examination notifications published in Tamil and English mediums.

M B L Rahuman

Deputy Director General (Admin )II

for Director General of Health Services

Specimen form of application

Efficiency Bar Examination and Departmental Examination for

Grade III / (II – ’B¶) Occupational Therapists – 2015

01. (a) i. Name of the Applicant : ............................................................................................................................

.....................................................................................................................................................................

ii. Name of the Applicant ( In block letters with initials at the end)

iii. Names denoted by initials ( In block letters )

(b) i. Date of first appointment :-.............................................................

ii. Reference number and the date of the letter

of confirmation :-............................................................

iii. Present Annual Salary :- ...........................................................................................

iv. Mobile phone number :-

v. National Identity Card Number :-

02. Subjects Offered ( Mark “” within the cages against the subjects you offer in this Examination. Mark “X”

against the subjects not offered)

Subject Related Question paper Practical

Office Administration & Establishment Code Viva Voce

Financial Regulations

03. (a) Present Station :- ..................................................................................................................................

(b) District of the Present Station :- ......................................................................................................

(c) Whether two self-addressed envelope in the size of 9 X 4 inches with stamps affixed to the value of

Rs. 30.00 has been attached to the application to post the Admission Card?..........................................

(d) Postal Address to post the Admission Card (In block letters.............................................................

...................................................................................................................................................................

For Office Use Only

04 Medium you sit for the examination.....................................................................................................................

05 (a) Whether you sit for the examination for the first time :- ...................................................................

(b) If so not, have you affixed stamps to the application?..................................................................

06. Certificate of the candidate :-

(i) I do hereby certify that the particulars furnished by me in this application are true and accurate to my

knowledge and I need not affix stamps since I sit the Examination for the first time / have affixed

stamps to the value of Rs. .......... since I repeat the Examination,* and the stamps affixed by me to the

application are genuine and not used before.

(ii) I agree to abide by the rules and regulations stipulated by the Department of Health for the conduct of

this Examination and if I was found ineligible in accordance with the scheme of the Examination I

agree with whatever decision taken for the cancellation of my candidature.

............................. ..........................................

Date Signature of the candidate

07 Certificate of Management Assistant

Particulars furnished in this application are true and accurate as per his$her personal File and kept a copy of

this application is attached to his$her persional file'

.............................. .......................................................

Date Signature of Management Assistant

08 Certificate of the Head of the Section

I hereby certify that *Mr/Mrs/Miss .......................................................................... in serving in my

section as a Pharmacist class II Seg. "B" /(Grade III).

..................................................

Date Signature of Head of the Section

09. Certificate of the Head of Decentralized unit / specialised Campaign

*Mr/Mrs/Miss .............................................................................. ........................ serves as a Occupational

Therapists Class II Seg. “B”/ (Grade III) in my Division / Campaign* and the particulars furnished by him /

her* in the Application are correct in accordance with the particulars available in his / her* personal file and

he / she* is eligible to sit for the Examination.

..................... .....................................................

Date Signature of Head of Decentralized Unit /

Specialised campaign

( Frank / Rubber stamp )

* - Delete words which are inapplicable

Stamp Cage