PERFORMANCE APPRAISAL REPORT FOR THE

YEAR OF 2021-2022 .

DESIGNATION: STAFF NURSE.

PART-I
S.NO. PERFORMANCE INCREMENT OF PAY PERCENTAGE
GRADE. TO BE GIVEN AS OF OF POINTS
LAST AGREEMENT OBTAINED.
SALARY.
1. MONITORNIG VITAL SIGNS. 10

2. ADHERENCE TO FTP. 10

3. MAINTENANCE OF 10
RECORDS AND REPORTS.
4. PROVISION OF 10
IMMUNIZATION SERVICES.

5. PROVISION OF AN AND PN 10
SERVICES.
6. ASSISSTING IN 10
MEDICATION.
7. PUNCTUALITY AND TIME 10
MANAGEMENT.

8. COMMUNICATION SKILLS. 10

9. PHYSICAL APPEARANCE 10
AND NEATNESS.

10. ASSISTENCE TO REFERRAL 10

PATIENTS.

TOTAL 100

PERCENTAGE OF POINTS OBTAINED = (POINTS

OBTAINED/TOTAL POINTS)X 100
 PART-II

BRACKET FOR INCREMENTS BASED OF PERFORMANCE

APPRAISAL:

PERCENTAGE OF PERFORMANCE INCREMENT OF PAY TO

POINTS OBTAINED . GRADE. BE GIVEN AS%OF LAST
AGREEMENT SALARY.
80 PERCENTAGE OR GRADE-A.
ABOVE.

70-79 PERCENTAGE . GRADE-B. ELIGIBLE FOR INCREMENT

ASPER NHM NORMS.
60-69 PERCENTAGE. GRADE-C.

50-59 PERCENTAGE. GRADE-D. NO INCREMENT

REVIEW THE PERFORMANCE
APPRAISAL AFTER 3 MONTHS
FOR INCREMENT.

40-49 PERCENTAGE. GRADE-E. NO INCREMENT

RENEWAL OF CONTRACT WITH
WARNING PERFORMANCE
APPRAISAL AFTER 3 MONTHS
FOR RENEWAL OF CONTRACT.

LESS THAN 40 GRADE-F. IT’S BETTER NOT TO RENEW.

PART - III
NAME OF THE OFFICER :
DESIGNATION :
DATE OF REVIEW :
REMARKS :
AREAS OF TRAINING :
PERFORMANCE GRADE :

SIGNATURE OF THE ASSESSOR