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Date – 01.01.

2024

To

The …………………………………..
………………………………………….

Dist. –………………………. (Raj.)

Sub: - Option form for Non-Clinical and Non-Practicing Allowance


Under Finance Department order No. F.6(3)FD/Rules/2008 amended on 28 June 2013

Option Form

I Dr. ………………………………… hereby opt to draw Non-Practicing Allowance and shall not
undertake any private practice and charge professional fee during year 2024.
(Month January to December)

Place –

Date – 01.01.2024

Signature

Dr. ……………………………………………….

MO/SMO/JS/SS/PS….

Copy forwarded to the; Hospital/Office name ……………………

1. CM&HO …………………..

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