mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c.

pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

mrIzW dI sur`iKAw qy hspqwl dw srvyKx

inrdyS –

ieh srvyKx mrIz dI sur`iKAw sMbMDI sm`isAwvW, mYfIkl glqI Aqy quhwfy hspqwl iv`c hoey iksy vI Gtnw
dI sUcnw sMbMDI quhwfI rwey pu`Cdw hY Aqy iesnUM pUrw hox iv`c lgBg 10 qoN 15 imMt l`gxgy[ jykr
qusIN iksy svwl dw jvwb nhIN dyxw cwhuMdy ho jW jykr koeI svwl quhwfy qy lwgU nhIN huMdw hY qW
qusIN jvwb C`f skdy ho[

 ie`k “Gtnw” nUM pirBwiSq kIqw jWdw hY iksy vI iksm dI glqI, Gtnw,
durGtnw, ivvhwr BwvyN ieh mrIz nUM nukswn phuMcwauNdw hY jW nhIN[

 “mrIzW dI sur`iKAw” nUM ishq sMBwl iflvrI dIAW pRikirAwvW dy nqIjy

vjoN mrIzW dIAW s`tW jW pRiqkUl GtnwvW qoN bcx Aqy rokQwm v`joN
pirBwiSq kIqw igAw hY[

Bwg ey : quhwfy kMm dw Kyqr jW XUint

ies srvyKx iv`c AwpxI kMm dy Kyqr jW XUint bwry soco ij`Qy qusIN Awpxw izAwdwqr smW ibqwauNdy ho jW
AwpxIAW izAwdwqr klInIkl syvwvW pRdwn krdy ho[

ies hspqwl iv`c quhwfw pRweImrI kMm Kyqr jW XUint kI hY? ie`k jvwb cuxo[

□ a) hspqwl dy v`K-v`K XUint/koeI Kws XUint nhIN[ □ g) mnoivigAwn /mYNtl hYlQ

□ A) mYfIsn (gYr srjIkl) □ G) rIhYblItySn
□ e) srjrI □ |) dvweIAW (PwrmysI)
□ s) gwienI □ c) lYb
□ h) pIfIAwtrIks □ C) rYfIalojI
□ k) AYmrjYNsI ifpwrtmYNt □ j) An`sQIsIalojI
□ K) AweIsIXU (koeI vI) □ J) hor (ikrpw krky inrDwirq kro)

ikrpw krky Awpxy kMm dy Kyqr jW XUint bwry hyTW id`qy ibAwnW nwl AwpxI sihmqI jW AsihmqI d`so[

iblkul Asihmq Asihmq nhIN sihmq iblkul sihmq

Awpxy hspqwl dy kMm dy Kyqr/XUint bwry soco……
1. lok ies XUint iv`c ie`k dUjy dw smrQn (swQ) krdy hn[………… □1 □2 □3 □4 □5
2. swfy kol izAwdw kMm nUM sMBwlx leI loVINdw stw& hY[…………… □1 □2 □3 □4
□5
3. jdoN bhuq swry kMm nUM jldI pUrw krn dI zrUrq huMdI hY qW
AsIN kMm nUM pUrw krn leI ie`k tIm dy rUp iv`c iek`Ty kMm krdy hW[ □1 □2 □3 □4
□5
2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 1 of 7
 mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c. pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

4. ies XUint iv`c lok ie`k dUjy nwl siqkwr nwl pyS AwauNdy hn[…… □1 □2 □3 □4 □5

Bwg ey : quhwfy kMm dw Kyqr/XUint (jwrI hY)

Awpxy hspqwl dy kMm dy Kyqr/XUint bwry soco…… iblkul Asihmq Asihmq nhIN sihmq iblkul sihmq

5. ies XUint iv`c stw& mrIz dI dyKBwl leI smyN nwloN v`D GMty
kMm krdw hY[……………………………………………………… □1 □2 □3 □4 □5
6. AsIN mrIz dI sur`iKAw nUM ibhqr bxwaux leI srgrmI (zorSor)
nwl kMm krdy hW[………………………………………………… □1 □2 □3 □4
□5
7. AsIN vDyry eyjyNsI jW AsQweI stw& dI vrqoN krdy hW qW jo mrIz
dI dyKBwl sB qoN vDIAw hovy[…………………………………… □1 □2 □3 □4
□5
8. stw& mihsUs krdw hY ik auhnW dIAW glqIAW auhnW dy ivruD hn[ □1 □2 □3 □4
□5
9. glqIAW kwrn ie`Qy skwrwqmk (pwzyitv) qbdIlIAW AweIAW hn[ □1 □2 □3 □4 □5
10. ieh kyvl sMXog hY ik ie`Qy hor gMBIr glqIAW nhIN hoeIAW[……… □1 □2 □3 □4
□5
11. jdoN ies XUint iv`c ie`k Kyqr ivAsq ho jWdw hY qW dUsry
mdd krdy hn[…………………………………………………… □1 □2 □3 □4 □5
12. jdoN iksy Gtnw dI irport kIqI jWdI hY qW Aijhw mihsUs huMdw hY ijvyN
ivAkqI nUM iliKAw jw irhw hY, nw ik sm`isAw[…………………… □1 □2 □3 □4
□5
13. jdoN AsIN mrIzW dI sur`iKAw iv`c suDwr krn leI bdlwA krdy hW
qW AsIN auhnW dI pRBwvSIlqw dw mUlWkx (pVqwl/jWc) krdy hW[… □1 □2 □3 □4
□5
14. AsIN sMkt mof iv`c bhuq izAwdw Aqy bhuq jldI kMm krn dI
koiSS krdy hW[…………………………………………………… □1 □2 □3 □4 □5
15. izAwdw kMm krvwaux leI mrIzW dI sur`iKAw nUM kdy vI kurbwn
nhIN kIqw jWdw[…………………………………………………… □1 □2 □3 □4 □5
16. stw& nUM icMqw hY ik auh jo glqI krdy hn jo auhnW dI
krmcwrIAW dI PweIl iv`c r`KI jWdI hY[………………………… □1 □2 □3 □4 □5
17. swfy kol ies XUint iv`c mrIzW dI sur`iKAw sMbMDI sm`isAwvW hn[ □1 □2 □3 □4
□5
18. swfIAW pRikirAwvW Aqy isstm glqIAW nUM hox qoN rokx leI
vDIAw hn[……………………………………………………… □1 □2 □3 □4 □5

2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 2 of 7
 mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c. pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

Bwg bI : quhwfw suprvweIzr/mYnyjr

ikrpw krky Awpxy qqkwl suprvweIzr jW mYnyjr jW ivAkqI ijs nUM qusIN is`Dy qOr qy irport krdy ho, hyTW id`qy
ibAwnW nwl AwpxI sihmqI jW AsihmqI drisAwau[
iblkul Asihmq Asihmq nhIN sihmq iblkul sihmq
1. myrw suprvweIzr cMgy Sbd (g`lW) kihMdw hY jdoN auh sQwpq
mrIz sur`iKAw pRikirAw dy Anuswr koeI kMm huMdw dyKdw hY[………… □1 □2 □3 □4
□5
2. myrw suprvweIzr/mYnyjr mrIzW dI sur`iKAw nUM ibhqr bxwaux
leI stw& dy suJwvW qy gMBIrqw nwl ivcwr krdw hY[……………… □1 □2 □3 □4
□5

Bwg bI : quhwfw suprvweIzr/mYnyjr (jwrI hY)

iblkul Asihmq Asihmq nhIN sihmq iblkul sihmq

3. jdoN vI kMm dw dbwA vDdw hY qW myrw suprvweIzr/mYnyjr cwhuMdw

hY ik AsIN qyjI nwl kMm krIey BwvyN ies dw mqlb Swrtk`t lYxw hovy[ □1 □2 □3 □4
□5
4. myrw suprvweIzr/mYnyjr mrIzW dI sur`iKAw sMbMDI sm`isAwvW nUM
nzrAMdwz krdw hY jo vwr-vwr vwprdIAW hn[…………………… □1 □2 □3 □4 □5

Bwg sI : g`lbwq (sMcwr)

quhwfy kMm dy Kyqr iv`c hyT ilKIAW g`lW ikMnI vwr vwprdIAW hn?

kdy nhIN G`t hI kdy kdweI izAwdwqr hmySw

Awpxy hspqwl dy kMm dy Kyqr/XUint bwry soco…

1. swnUM ievYNt irportW dy AwDwr qy kIqy gey bdlwA bwry PIfbYk

id`qw jWdw hY[………………………………………………… □1 □2 □3 □4 □5
2. stw& Kul ky g`l krygw jykr auh kuJ Aijhw dyKdy hn jo mrIz
dI dyKBwl nUM nkwrwqmk qOr qy pRBwivq kr skdw hY[………… □1 □2 □3 □4
□5
3. swnUM ies XUint iv`c hox vwlIAW glqIAW bwry sUicq kIqw jWdw hY[ □1 □2 □3 □4
□5
4. stw& vDyry AiDkwrW vwly lokW dy PYsilAW jW kwrvweIAW qy
svwl krn leI suqMqr mihsUs krdw hY[………………………… □1 □2 □3 □4 □5
5. ies XUint iv`c AsIN glqIAW nUM dubwrw hox qoN rokx dy qrIikAW
bwry crcw krdy hW[……………………………………………… □1 □2 □3 □4 □5
6. jdoN kuJ shI nhIN l`gdw qW stw& svwl pu`Cx qoN frdw hY[………… □1 □2 □3 □4 □5

2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 3 of 7
 mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c. pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

Bwg fI : GtnwvW dI bwrMbwrqw (iPrIkuAYNsI) irport

quhwfy hspqwl dy kMm dy Kyqr jW XUint iv`c jdoN hyT ilKIAW glqIAW huMdIAW hn qW auhnW nUM ikMnI vwr
irport kIqw jWdw hY?
kdy nhIN G`t hI kdy kdweI izAwdwqr hmySw

1. jdoN koeI glqI ho jWdI hY, pr mrIz nUM pRBwivq krn qoN pihlW PVI
jWdI hY, Aqy suDwrI jWdI hY, ieh ikMnI vwr irport kIqI jWdI hY?... □1 □2 □3 □4
□5
2. jdoN koeI glqI ho jWdI hY, mrIz nUM nukswn phuMcwaux dI koeI
sMBwvnw nhIN huMdI, qW ieh ikMnI vwr irport kIqw jWdw hY?............ □1 □2 □3 □4
□5
3. jdoN koeI glqI ho jWdI hY, qW ieh mrIz nUM nukswn phuMcw
skdI hY, pr nhIN, ieh ikMnI vwr irport kIqI jWdI hY?............... □1 □2 □3 □4 □5

Bwg eI : mrIz sur`iKAw gryf

ikrpw krky ies hspqwl iv`c Awpxy kMm dy Kyqr jW XUint nUM mrIzW dI sur`iKAw qy ie`k smu`cw gRyf ida[

□ □ □ □ □
eyy bI sI fI eI
Swndwr bhuq vDIAw sivkwr Xog mwVw/GitAw AsPl

Bwg AY~& : quhwfw hspqwl

ikrpw krky Awpxy hspqwl bwry hyTW id`qy ibAwnW nwl AwpxI sihmqI jW AsihmqI bwry d`so[

iblkul cMgI qrHW

Asihmq Asihmq nhIN sihmq cMgI qrHW sihmq
Awpxy hspqwl bwry soco…

1. hspqwl mYnyjmYNt iv`c kMm dw mhOl pRdwn krdw hY jo

mrIz dI sur`iKAw nUM auqswihq krdw hY[……………… □1 □2 □3 □4
□5
2. hspqwl XUint ie`k dUjy nwl cMgI qrHW qwlmyl nhIN r`Kdy[… □1 □2 □3 □4
□5
3. mrIzW nUM ie`k XUint qoN dUjI XUint iv`c iS&t krn vyly
cIzW cIr dy ivckwr AwauNdIAW hn[................................. □1 □2 □3 □4 □5
4. hspqwl dy hr XUint dy ivckwr cMgw sihXog hY ijnHW
nUM iml ky kMm krn dI loV hY[……………………………… □1 □2 □3 □4
□5
5. iS&t qbdIlI dOrwn mrIz dI dyKBwl dI mh`qvpUrn

2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 4 of 7
 mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c. pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

jwxkwrI Aksr guMm ho jWdI hY[…………………………… □1 □2 □3 □4 □5

6. hspqwl dy hor XUint dy stw& dy nwl kMm krnw
vDIAw nhIN l`gdw[ (duKdweI huMdw hY)[……………………… □1 □2 □3 □4
□5
7. sm`isAwvW Aksr hspqwl dy XUint iv`c jwxkwrI
dy Awdwn pRdwn dOrwn huMdIAW hn[………………………… □1 □2 □3 □4
□5
8. hspqwl mYnyjmYNt dIAW kwrvweIAW drswauNdIAW hn
ik mrIzW dI sur`iKAw aunHW leI pRmu`K kMm hY[……………… □1 □2 □3 □4 □5
9. koeI pRqIkUl (mwVI) Gtnw vwprn qoN bwAd hI hspqwl
mYnyjmYNt mrIz dI sur`iKAw iv`c idlcspI r`Kdw hY[………… □1 □2 □3 □4
□5
10. hspqwl dy XUint mrIz dI sB qoN vDIAw dyKBwl
pRdwn krn leI iml ky kMm krdI hY[……………………… □1 □2 □3 □4 □5
11. ies hspqwl dy mrIzW leI iS&t qbdIlIAW (AOKw)
sm`isAwvW hn[……………………………………………… □1 □2 □3 □4 □5

Bwg jI : irport kIqIAW GtnwvW dI igxqI

ipCly 12 mhInIAW iv`c qusIN ikMnIAW ievYNt (GtnwvW) irportW BrIAW Aqy jmHW kIqIAW hn?

□ a) koeI ievYNt irport nhIN[ □ s) 6 qoN 10 ievYNt irport

□ A) 1 qoN 2 ievYNt irport □ h) 11 qoN 20 eIvYNt irport
□ e) 3 qoN 5 ievYNt irport □ k) 21 ievYNt irport jW v`D

Bwg AY~c : ipClyrI jwxkwrI

ieh jwxkwrI srvyKx dy nqIijAW dy ivSlySx iv`c mdd krygI[

1. qusIN ies hspqwl iv`c ikMnw smW kMm kIqw hY?

□ a) 1 swl qoN G`t □ s) 11 qoN 15 swl
□ A) 1 qoN 5 swl □ h) 16 qoN 20 swl
□ e) 6 qoN 10 swl □ k) 21 swl qoN izAwdw
2. qusIN Awpxy mOjUdw hspqwl dy kwrj Kyqr jW XUint iv`c ikMnw smW kMm kIqw hY?
□ a) 1 swl qoN G`t □ s) 11 qoN 15 swl
□ A) 1 qoN 5 swl □ h) 16 qoN 20 swl
2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 5 of 7
 mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c. pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

□ e) 6 qoN 10 swl □ k) 21 swl qoN izAwdw

3. Awm qOr qy qusIN ies hspqwl iv`c ie`k h&qy iv`c ikMny GMty kMm krdy ho?
□ a) pRqI h&qy 20 GMty qoN G`t □ s) pRqI h&qy 60 qoN 79 GMty
□ A) pRqI h&qy 20 qoN 39 GMty □ h) pRqI h&qy 80 qoN 99 GMty
□ e) pRqI h&qy 40 qoN 59 GMty □ k) pRqI h&qy 100 GMty jW aus qoN v`D[
4. ies hspqwl iv`c quhwfI stw& dI siQqI kI hY? ie`k jvwb cuxo jo quhwfy stw& dI siQqI dw sB qoN vDIAw vrnx kry[
□ a) rijstrf nrs □ g) Awhwr ivigAwnI (fwietISIAn)
□ A) fwktr shwiek/nrs pRYktISnr □ G) XUint shwiek/klrk/sYkryqrI
□ e) AY~lvIAY~n/AY~lpIAY~n □ |) swh sMbMDI QYryipst
□ s) mrIz dyKBwl shwiek/hspqwl shwiek/dyKBwl shwiek □ c) srIrk/ik`qwmuKI jW spIc QYryipst
□ h) AtYNifMg/stw& fwktr □ C) qknISIAn (ijvyN eIkyjI, lYb, ryfIElojI)
□ k) rYzIfYNt fwktr/trYnI fwktr □ j) pRSwsn/mYnjmYNt
□ K) Pwrmwisst □ J) hor (ikrpw krky inrDwirq kro)

Bwg AY~c : ipClyrI jwxkwrI (jwrI hY)

5. quhwfI stw& dI siQqI iv`c, kI qusIN Awm qOr qy mrIzW nwl is`Dw sMprk krdy ho?
□ a) hW, myrw Awm qOr qy mrIzW nwl is`Dw sMprk huMdw hY[
□ A) nhIN, myrw Awm qOr qy mrIzW nwl is`Dw sMprk nhIN huMdw hY[
6. qusIN AwpxI mOjUdw ivSySqw jW pySy iv`c ikMnw smW kMm kIqw hY?
□ a) 1 swl qoN G`t □ s) 11 qoN 15 swl
□ A) 1 qoN 5 swl □ h) 16 qoN 20 swl
□ e) 6 qoN 10 swl □ k) 21 swl jW aus qoN izAwdw

Bwg AweI : quhwfIAW it`pxIAW (kmYNt)

ikrpw krky Awpxy hspqwl iv`c mrIz dI glqI jW Gtnw dI irporitMg bwry koeI vI it`pxI ilKx leI suqMqr mihsUs kro[

2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 6 of 7
 mrIz dI sur`iKAw Aqy dyKBwl dI guxv`qw AY~n.ey.bI.AY~c. pRvwinq
dXwnMd mYfIkl kwlj Aqy hspqwl, luiDAwxw

ies srvyKx nUM pUrw krn leI quhwfw DMnvwd[

2.2.1
DMCH/F/C/P/Q&S.18/2593.2022.2.1 Page 7 of 7