MTI-KHYBER TEACHING HOSPITAL

(Medical Teaching Institution)

HUMAN RESOURCE
Employee Leave Form
ISSUE #: 01 DOCUMENT #: HR-F-11 ISSUE DATE: 01-09-2021

SECTION-I (To be filled by the Applicant)

Date ____________________

NAME _________________________ EMP ID# ____________________ D.O.J _____________________

DESIGNATION_____________________________ DEPARTMENT _______________________________

TYPE OF EMPLOYEE: (TICK ONE)

Civil Institutional MTI Employee Fixed Pay Daily Wages

DURATION OF LEAVE & DAYS:

From: ________________________ To ______________________ Total Leave Days: __________________
1st day of Leave Last Day of Leave

Date Return to Work____________________

RELEIVED BY: __________________________ Signature_______________________________________

REASON OF LEAVE: _____________________________________________________________________

TYPE OF LEAVE APPLIED:

Earned Casual Sick Conference/ Edu Hajj / Umrah Short

Leave without pay Maternity Other ______________________

Recommended Not Recommended

Remarks: ________________________________________________________________________________

_______________________ _____________________________
Signature of Employee Dept. Head/ Designation/ Signature

SECTION-II (Human Resource Department)

LEAVE CALCULATION:
Consumed
Type of Leave Opening Balance Currant Balance
Leaves

Annual

Casual

Sick
Other Leaves

Study Hajj Maternity Unpaid

Entitlement: Comments (if any)______________________________________HRO(Leave)____________________

Signature

SECTION-III (Competent Authority)

Approved Not Approved

Name______________________ Designation____________________ Signature ____________

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