For All categories

Of contract employees CONFIDENTIAL

GOVERNMENT OF THE PUNJAB

HEALTH DEPARTMENT
PERFORMANCE EVALUATION REPORT
For the period:- _____________to________________
PART -1

1. Name (in Block letters) with Father’s name:- _________________________________________

2. Date of Birth:- ____________________

3. Domicile:- ______________________

4. B.S with present pay:- ____________

5. Post held during the period:- _____________________________

6. Academic/ Professional qualifications:- ___________________________

7. Period served. ___________________________________________________

a. In present post:- _______________________

b. Under reporting officer:- ___________________________

8. Signature of the official report upon with date:- _______________________________

 1. INTEGRITY

Honest Reported to Believed to

Be corrupt Be corrupt

OVERALL GRADE

Comparing him with other Employees of the same level and keeping in view be evaluation on account of
personal of Qualities, attitudes proficiency in job, integrity, Efficiency, Punctuality etc. General
assessment of the employees by initiative the appropriate below.

I Very Good
II Good
III Average
IV Below Average
V Poor

III. USEFULNESS FOR RETENTION / EXTENSION IN SERVICE

Useful Not Useful

Name of Reporting Officer ________________________________Signature____________________

Designation______________________________________________ Date______________________

IV. Name of Counter Signing Officer_____________________________ Signature________________

Designation___________________________________________________ Date__________________