Gllej ØeosMe YetlelJe SJeb Keefvekeâce& Advertisement No.

-
UTTAR PRADESH PUBLIC SERVICE COMMISSION
efveosMeeueÙe DeOeervemLe ØeeefJeefOekeâ mesJee D-1/E-1/2024
Date: 15.03.2024
DATE OF COMMENCEMENT OF ONLINE APPLICATION : 15.03.2024
LAST DATE FOR THE PAYMENT OF ONLINE APPLICATION FEE IN THE BANK : 12.04.2024
LAST DATE FOR SUBMISSION OF ONLINE APPLICATION : 16.04.2024
LAST DATE FOR CORRECTION/MODIFICATION IN SUBMITTED ONLINE APPLICATION : 23.04.2024
LAST DATE FOR SUBMISSION OF HARD COPY OF ONLINE APPLICATION ALONGWITH DOCUMENTS: 30.04.2024
IMPORTANT- O.T.R.' will be displayed with respect to the examination and date and time fixed for it. Candidates should take a print
(1) (i) It is mandatory for the candidates to make on clicking 'Authenticate with O.T.R.', 'Have You out of the same and keep it safe. (ii) If the candidate does
Completed Your O.T.R. Registration' will be displayed, in not provide the relevant documents in support of his/
One Time Registration (O.T.R.) and obtain O.T.R. her online application, his/her candidature shall be
which the candidate will have to tick 'Yes' or 'No'. If the
Number before applying online. candidate:- rejected by the commission.
(ii) Without O.T.R. Number the submission of (i) Ticks on 'Yes' and clicks on 'Go' button, 'Enter your DEPARTMENT OF MEDICAL HEALTH & FAMILY
Online application will not be possible. O.T.R. Number' will be displayed wherein he/she has to fill WELFARE, U.P. (ALLOPATHY)
(iii) Those Candidates who have not obtained O.T.R. Number and click on 'Proceed' button. On clicking 2532 Posts of Medical Officer grade-II (Level-2), Nature
O.T.R. Number, must obtain it from commission's 'Proceed' button, 'Click here to Authenticate' will be of post - Group 'A' Gazetted, Reservation - As per existing
website https://otr.pariksha.nic.in 72 hours displayed, clicking whereupon the candidate may rules, Pay Scale - 67700-208700, Level-11, Age Limit - 21
before the submission of Online application. authenticate through O.T.P. received on his/her registered to 40 years (Age relaxation is permissible as per rules).
(iv) Only after obtaining O.T.R. Number a mobile no./email ID or O.T.R.-password. Having completed Number of posts in different specialities is as under:-
candidate may submit online application through the process of Authentication, all personal details of the S. Medical Officer Grade-II Deptt.
commission's website https://uppsc.up.nic.in. candidate (as filled in O.T.R.) will be displayed N. Specialist Level-2 (Direct No.
(2) Incomplete Online Application-Form shall be rejected automatically. The candidate will have to fill only essential Recruitment)
and no communication in this regard shall be entertained. qualification as required for the post. 1 Gynaecology 385 S-8/01
(3) If at any stage, it comes to the knowledge of the (ii) Ticks on 'No' and clicks on 'Go' button:- (a) First of all, the 2 Anesthetist 460 S-8/02
commission that the candidate has concealed or candidate has to obtain One Time Registration Number from 3 Pediatrician 440 S-8/03
misrepresented any information, his candidature shall be O.T.R. Web-portal (https://otr.pariksha.nic.in) of the
rejected and proceeding to debar him/her from future Commission. (b) After obtaining O.T.R. number the 4 Radiologist 70 S-8/04
examinations and selections shall be initiated. candidate will have to apply online according to the process 5 Pathologist 21 S-8/05
(4) At the time of online application the candidates are adopted in First Stage. 6 Ophthomologist 23 S-8/06
directed to ensure the preservation of information Second Stage:- The First Stage procedure having been 7 Orthopaedician 22 S-8/07
regarding all the stages (i.e. O.T.R., Fee payment, Final completed the 'Applicant Dashboard' will automatically 8 ENT Specialist 25 S-8/08
submission, Qualification related modification/Error be displayed on the screen. The candidate will have to 9 Dermatologist 52 S-8/09
correction etc.) in Soft/Hard copy for future references. click on 'Submit Details' under 'Application Part-2' 10 Psychiatrist 37 S-8/10
NOTE- (1) Candidates after submitting their applications against applied post, thereafter the permanent and 11 Microbiologist 08 S-8/11
through online shall send self attested photo copies of their correspondence address along with application form 12 Forensic Specialist 57 S-8/12
all academic/required documents regarding their claims will automatically be displayed on the screen from 13 Public Health 10 S-8/13
along with printout of online form till ................... 05:00 P.M. O.T.R. along with the preferential qualifications Specialist
through registered/speed post or by hand in the office of the prescribed for the post. The candidate will have to choose 14 General Surgeon 338 S-8/14
Commission. For this purpose proforma of Address Slip is Yes/No option against each preferential qualification 15 Uro Surgeon 19 S-8/15
as below:- according to his/her eligibility for the same. 16 Neuro Surgeon 18 S-8/16
Advertisement No. : ................ Third Stage:- After the completion of the procedure of 17 Chest Surgeon 01 S-8/17
Post Name : Second Stage, 'Fee Confirmation Window' will 18 Plastic Surgeon 50 S-8/18
Deptt. No. : automatically be displayed on the screen under which upon 19 Gastro Surgeon 02 S-8/19
O.T.R. No. : clicking on 'Yes' option in front of 'Proceed for fee payment' 20 General Physician 316 5-8/20
Application ID : Home page of 'SBI MOPS' will be displayed comprising of 21 Cardiologist 134 S-8/21
To, 03 modes of payment:- (i) NET BANKING (ii) CARD 22 Neuro Physician 19 S-8/22
The Secretary, PAYMENTS and (iii) OTHER PAYMENT MODES.
23 Nephrologist 20 S-8/23
Uttar Pradesh Public Service Commission, After payment of the required fee by any one of the above
24 Gastro Physician 05 S-8/24
10, Kasturba Gandhi Marg, Prayagraj, U.P. prescribed modes, 'Payment Transaction Slip' shall be
displayed alongwith detail of fee payment, the print of which Total 2532
Pin Code-211018 Note:- 1. Horizontal reservation will be as per rules, for
From must be taken by clicking on 'Printer Icon'. In the event of
'Payment Failed' the candidate has to go to 'Candidate physically handicapped person, only O.A. (One Arm
Name & Address of the Candidate Affected), O.L. (One Leg Affected), L.V. (Low Vision), Dw
Dashboard login' and after filling the O.T.R. number proceed
The candidates are advised to login to the 'Candidate (Dwarfism) and A.A.V. (Acid Attack Victims) candidates are
to authenticate through O.T.P. or O.T.R. password and click
Dashboard (O.T.R. Based)' on the commission's website, 'Pending Payment' to pay the fee, compulsorily for online eligible for the above post.
download and take printout of the address-slip and paste it application. 2 (i). Post of S.N.-15 Uro Surgeon, S.N.-16 Neuro Surgeon,
on the envelope containing application and documents. In S.N.-17 Chest Surgeon, S.N.-18 Plastic Surgeon and S.N.-
absence of required relevant documents, the claim made Fourth Stage:- After completing the procedure of the 19 Gastro Surgeon are the posts of Super Specialty under
by the candidates shall not be tenable and relevant Third Stage the application form of the candidate will the post of S.N.-14 General Surgeon.
documents received after due date in the office of the automatically be displayed on screen the print of Post of S.N.-21 Cardiologist, S.N.-22 Neuro Physician, S.N.-
Commission will not be accepted. which may be obtained by the candidate. If candidate 23 Nephrologist and S.N.-24 Gastro Physician are the posts of
does not complete the process of online Super Specialty under the post of S.N.-20 General Physician.
(2) The envelope should be of A-4 size. In case of applying
for more than one post candidates must send their application, his/her candidature will not be 2 (ii). lqij Lis'kfyVh dh fo'ks"kKrk ds vuqlkj vH;FkhZ miyC/k u
application form & documents etc. for each post in a accepted for which he will entirely be responsible. gksus ij ewy fo'ks"kKrk tujy ltZu ,oa tujy fQftf'k;u ds inksa
separate envelope. The candidate will have to take the print of online ij p;u dh dk;Zokgh dh tk;sxhA
Educational Qualification (Essential) and other
(3) If the candidate does not mention the Advertisement application and keep it safe with himself/herself to Qualifications- (i) MBBS degree of a university recognized
number, Department number, OTR No./Application ID in produce it in the office of the commission when required by the 'Medical Council of India' or an undergraduate
the format of the Address Slip, his candidature may be in case of any discrepancy, else his/her request/claim medical degree recognized under 'The National Medical
cancelled by the Commission. will not be accepted. After applying, in case of any Commission Act, 2019' and (ii) Postgraduate Degree (3
SPECIAL NOTICE :- (a) The candidates will be entirely modification in the qualification of applied post, the years) in the concerned Specialty of a university recognized
responsible for on-line submission of application. The candidate may click on 'Candidate Dashboard Login' of by the 'Medical Council of India' or a Post-Graduate Medical
application of the candidate will be accepted only after the degree recognized under 'The National Medical
'Home Page' to modify it only once till last date and time Commission Act, 2019', or (iii) Postgraduate Diploma (2
payment of the fee in the bank till the last date. (b) All future
information/instructions will be sent to the registered
fixed for it. years) in the concerned Speciality of a university recognized
mobile number and email ID as registered in O.T.R. by 2. Application Fee : After completing the process of First by the Medical Council of India or a Post-Graduate medical
SMS or email. Candidates are also directed to visit the and Second Stage in the online application process, deposit diploma recognized under 'The National Medical Commission
website of the commission. the fee category wise as per the instructions given in the Act, 2019' and with at least one year of experience in the
Third Stage. The prescribed fee is as follows:- concerned Speciality after registration of the diploma in the
IMPORTANT INFORMATION FOR CANDIDATES
(i) Unreserved/ - Application fee Rs. 80/- + On-line concerned Medical Council. Specialty-wise educational
APPLYING ONLINE qualification for Medical Officer Grade-II:-
This advertisement is also available on the website Economically process fee Rs. 25/- Total =
of the commission https://uppsc.up.nic.in. 'O.T.R. Weaker Sections/ Rs. 105/- Sl. Section-A Section-B
BASED APPLICATION' system is applicable for Other Backward No. Specialist Requisite Post Requisite Post
applying against this advertisement. Application sent Classes Graduate Degree Graduate Diploma
through any other medium will not be accepted. (ii) Scheduled Castes/ -Application fee Rs. 40/- + On-line Qualification Qualification
Therefore candidates have to apply online only. Scheduled Tribes process fee Rs. 25/- Total = 1 Gynecologist M.D. (Obstetrics Diploma in
The candidates applying online are expected to go & Gynaecology) Obstetrics and
Rs. 65/-
through the following instructions thoroughly and apply M.S. (Obstetrics Gynaecology
accordingly:- (iii) Disabled Category - Application fee NIL/- + On-line
& Gynaecology)
1. When the candidate clicks on the "ALL NOTIFICATIONS/ process fee Rs. 25/- Total =
2 Anesthetist M.D.(Anesthesiology) Diploma in
ADVERTISEMENTS" in the Commission's website Rs. 25/- Anaesthesia
https://uppsc.up.nic.in, the ONLINE ADVERTISEMENTS (iv) Ex-Servicemen - Application fee Rs. 40/- + On-line 3 Pediatrician M.D. (Paediatrics) Diploma in Child
will automatically be displayed, which has following 3 parts:- process fee Rs. 25/- Total = Health
(i) User Instructions Rs. 65/-
(ii) View Advertisement 4 Radiologist M.D. (Radio- Diploma in Radio
(v) Dependents of the - According to their original Diagnosis) Diagnosis
(iii) Apply
Freedom Fighters/ category M.D. (Radiology)
The Instructions for filling Online form have been given
in User Instructions. The candidates desirous to see the Women/Skilled Player 5 Pathologist M.D. (Pathology) Diploma in Clinical
respective advertisement will have to click on "View 3. If the claim made by the candidate in the application is not Pathology
Advertisement". Thereafter, a full advertisement will be found to be true, action may be taken to debar the candidate M.D. (Lab Medicine) Diploma in Path. &
displayed alongwith Sample Snapshots of Online from this and all the future selections/examinations of the Bact.
Application procedure. Commission and other punitive action may also be taken. M.D. (Bio-Chemistry) Diploma in
'Online Application' will be completed in four stages:- Note: (i) It is mandatory to make payment in the 'ONLINE Transfusion
First Stage :- On clicking 'Apply' , 'Authenticate with APPLICATION' Process by the candidate till the last Medicine

Page-1
6 Ophthal- M.S. (Ophthalmology) Diploma in Degree or Diploma in Social Service, Applied Sociology, Social 5. Conditions of Eligibility: In case of emergency
mologist Opthalmology Science, Social Technique, Social Work or Social Service commissioned/short service commissioned officers
M.D. (Ophthalmology)Diploma in Administration; (iii) A degree in Law; (iv) Practical experience (For age relaxation only):- In accordance with the
OphthalmicMedicine of prohibition and Social Uplift. (B) Preferential provisions of the G.O. No. 22/10/1976-karmik-2-85, dated
Qualification- A candidate who has- (i) served in the 30-1-1985 Emergency Commissioned/Short Service
and Surgery. Territorial Army for a minimum period of two years, (ii) Commissioned Officers who have not been released from
7 Orthopedician M.S.(Orthopaedics) Diploma in obtained a 'B' certificate of National Cadet Corps, shall other Army but whose period of Army service has been extended
M.S.(Traumatolory Orthopaedics things being equal, be given preference in the matter of for rehabilitation, may also apply for this examination on the
and Surgery) direct recruitment. following conditions: (A) Such applicants will have to obtain
8 E.N.T. M.S. (E.N.T.) Diploma in Ot-Rhino- Note:- Horizontal reservation will be as per rules, for a certificate of the competent authority of Army, Navy, Air
Specialist Laryngology physically handicapped person only H.H.(Hard of Hearing), Force to the effect that their period of Service has been
9 Dermetologist M.D. (Dermatology) Diploma in Dw.(Dwarfism), A.A.V.(Acid Attacks Victims) candidates are extended for rehabilitation and no disciplinary action is
Dermatology eligible for the above post. pending against them. (B) Such applicants will have to
M.D. (Venereology) Diploma in Relevant Service Rule of the Post submit in due course a written undertaking that in case they
Venereology * The U.P. Prohibition (Excise) Gazetted Service Rules, 1982 are selected for the post applied for, they will get
themselves released immediately from the Army Service.
Diploma in Leprosy Sugar Industry & Cane Development Department, U.P. The above facilities will not be admissible to Emergency/
Diploma in Name of post- Regional Publicity Officer, Number of the Short Service Commissioned Officers, if (a) he gets
Dermatology post- Total-01 Post (SC), Nature of Post- Group 'B' permanent Commission in the Army, (b) he has been
Venereology and Gazetted, Deptt. No.- S-7/01, Pay Scale- 15600-39100, released from the Army on tendering resignation, (c) he has
Leprosoy Grade Pay-5400/- Pay matrix Rs. 56100-177500, Age- 21 to been released from the Army on grounds of misconduct or
10 Psychiatrist M.D. (Psychiatry) Diploma in 40 years (Age relaxation is permissible as per rules). physical disability or on his own request and who gets
Psychological Academic Qualifications- (i) Minimum Qualifications- 1- gratuity.
Bachelor's degree from a recognised University in at least 6. After receipt of application in the Commission, any
Medicine second division preferably with Hindi Literature and/or
11 MicrobiologistM.D. (Bacteriology) Diploma in request for change in the qualification and category will not
English Literature. 2- A Diploma in journalism or experience be entertained.
M.D. (Microbiology) Microbiology of at least three years in journalism or publicity work in any 7. Minimum educational qualification is not sufficient for
12 Forensic M.D. (Forensic Diploma in Forensic recognised institution or Government Department/Co- being called for interview. Mere eligibility does not entitle a
Specialist Medicine) Medicine operative Organisation/Public Undertaking. The candidate candidate to be called for interview or for selection.
M.D. (Forensic should have the experience of publishing articles, stories, Intimation for interview will be sent later on.
Medicine and dramatic plays, poems written by himself. (ii) Preferential 8. In case of large number of applicants for the post/ posts,
Toxicology) Qualifications- The candidate should have experience of the Commission may hold screening test, which will be
13 Public Health M.D. (Social & Diploma in organising exhibition or possess degree/diploma in communicated in due course of time. Under the conditions
commercial/ fine arts or have at least two years experience of holding screening test (Objective Type), penalty
Specialist Preventive Medicine) CommunityMedicine of editorship of newspaper or magazines. B. Preferential
M.D. (Community Diploma in Public (Negative Marking) shall be imposed for wrong answers
Qualifications- A candidate who has- (i) served in the given by the candidates in the manner given below--
Medicine) Health Territorial Army for a minimum period of two years, (ii) (i) There are four alternatives for the answer to every
M.D. (Community Master in Public obtained a 'B' certificate of National Cadet Corps, shall other question. For each question for which a wrong answer has
Health Administration) Health things being equal, be given preference in the matter of been given by the candidate, one third (0.33) of the marks
Master in Public direct recruitment to the Service. assigned to that question will be deducted as penalty.
Health Note:- Horizontal reservation will be as per rules, for (ii) If a candidate gives more than one answer, it will be
(Epidemiology) physically handicapped person only O.A.(One Arm treated as a wrong answer even if one of the given answer
Affected), O.L.(One Leg Affected), L.V.(Low Vision), H.H. happens to be correct and there will be same penalty as
Master Degree in (Hard of Hearing), L.C.(Leprosy Cured), Dw. (Dwarfism),
Applied above for that question.
A.A.V.(Acid Attacks Victims) candidates are eligible for the
(Epidemiology) above post. (iii) If a question is left blank i.e. no answer is given by the
14 General M.S. (General ---- candidate, there will be no penalty for that question.
Relevant Service Rules of the post
Surgeon Surgeon) 9. At the time of examination, candidates must fill all
* The Uttar Pradesh Cane (Gazetted) Service Rules, 1979 the information sought on the OMR Answer Sheet
15 Uro Surgeon M.C.H./D.N.B. Urology ---- * The Uttar Pradesh Cane (Gazetted) Service (First correctly by blackening the concerned circles, which
16 Neuro M.C.H./D.N.B. ---- Amendment) Rules, 1995 are decipherable by the scanner machine. The
Surgeon Neuro Surgery Uttar Pradesh Tourism Directorate Commission will evaluate OMR Answer Sheet only on the
17 Chest M.C.H./D.N.B. ---- Name of Post- Regional Tourist Officer/Publicity Officer, basis of information given by blackening the concerned
Surgeon Cardiothoracic Number of Post- Total- 01 Post (SC), Nature of Post- circles of OMR Answer Sheet. The candidates are also
Surgery Group 'B' Gazetted, Deptt. No.- S-9/01, Pay Scale- Level- directed not to use whitener, blade, pin or rubber etc. on
18 Plastic M.C.H./D.N.B. ---- 10, Pay scale (minimum) 15600, Pay scale (maximum) the OMR Answer Sheet. In case of not blackening the
39100 Grade Pay Rs. 5400/-, Age Limit- 21 to 40 years (Age circles properly in the OMR Answer Sheet and filling any
Surgeon Plastic Surgery relaxation is permissible as per rules). (A) Academic
19 Gastro M.C.H./D.N.B.Surgical ---- information incorrectly, the Commission shall not
Qualifications- (1) Essential Qualifications: vH;FkhZ& ¼d½ evaluate such OMR Answer Sheet for which candidates
Surgeon Gastroenterology/ Hkkjr esa fof/k }kjk LFkkfir fdlh fo'ofo|ky; dh mikf/k ;k ljdkj }kjk themselves shall be wholly responsible.
G.I. Surgery mlds led{k ekU;rk izkIr dksbZ vgZrk j[krk gks] vkSj ¼[k½ fgUnh vkSj vaxzsth 10. The original certificates are required for verification at
20 General M.D.(General Diploma in i<+us] fy[kus vkSj ckr djus dh iw.kZ {kerk gksA (2) Preferential the time of interview. Candidate will then also be required to
Physician Medicine) General Medicine Qualifications- ,sls vH;FkhZ dks lh/kh HkrhZ esa vf/keku fn;k tk;sxk] tks& submit his/her passport size photograph attested by head
M.D.(Family Medicine) Diploma in ¼d½ bfrgkl] Hkwxksy] vaxzsth lkfgR;] ekuo 'kkL=] vFkZ'kkL= ;k okLrqf'kYi esa of department or head of the institution, where he/she
Emergency Medicine ls fdlh ,d fo"k; ds lkFk Lukrd dh mikf/k j[krk gks( ;k ¼[k½ ljdkj }kjk received last education or by a Gazetted Officer.
M.D. (Emergency Diploma in 11. Candidates serving under Central or State Government
ekU;rk izkIr fdlh laLFkk dk i;ZVu] gksVy izcU/k] O;kikj izcU/k] tulEidZ] will have to produce "NO OBJECTION CERTIFICATE"
Medicine) Diabetology i=dkfjrk] lkewfgd lapkj esa fMIyksek@mikf/k j[krk gks( ;k ¼x½ vaxzsth ls
M.D.(Geriatrics) from their employer at the time of interview.
fHkUu fdlh fons'kh Hkk"kk esa fdlh ekU;rk izkIr laLFkk dk izek.k&i= j[krk gks( 12. The decision of the Commission as to the eligibility or
M.D.(Pulmonary ;k ¼?k½ ;k=k&O;olk; esa fdlh ;k=k vk;ksftr djus okyh laLFkk dk otherwise of a candidate will be final.
Medicine) izek.k&i= j[krk gks( ;k ¼³½ lkekU; Kku vkSj dEI;wVj esa fdlh ekU;rk izkIr 13. Candidates of any reserved category, if they want the
M.D.(Respiratory laLFkk dk izek.k&i= j[krk gksA (B) Preferential Qualifications- A benefit of reservation, must mention their category/
Medicine) candidate who has-- (i) served in the Territorial Army for a subcategory (one or more than one, whichever) in the
M.D.(Internal minimum period of two years; or (ii) obtained a 'B' certificate column related to O.T.R. (because all the personal
Medicine) of the National Cadet Corps, shall, other things being equal, information will be automatically displayed in the
M.D. (Tuberculosis be given preference in the matter of direct recruitment. application form from the O.T.R.).
& Chest Diseases) Note:- Horizontal reservation will be as per rules, for 14. It is very important to make the payment in the 'ONLINE
21 Cardiologist D.M./D.N.B. ---- physically handicapped person only O.A.(One Arm APPLICATION' process by the candidate till the last date
Affected), O.L.(One Leg Affected), L.C.(Leprosy Cured), and time of submission of complete application in all
Cardiology Dw.(Dwarfism), A.A.V.(Acid Attacks Victims) candidates are respects. Candidates should take a print of the information
22 Neuro D.M./D.N.B. ---- eligible for the above post. filled by them and keep it safe.
Physician Neurology Relevant Service Rules of the post In case of any discrepancy, the candidate will have to
23 Nephrologist D.M./D.N.B. ---- * The Uttar Pradesh Tourism Service Rules, 1980 submit the printout to the Commission's office otherwise the
Nephrology * The Uttar Pradesh Tourism Service (First Amendment) request of the candidate will not be accepted.
24 Gastro D.M./D.N.B. ---- Rules, 1990 15. With regard to claims made in the 'On-line Application',
Physician Gastroenterology * mÙkj izns'k i;ZVu lsok ¼f}rh; la'kks/ku½ fu;ekoyh] 1998 the candidate shall submit the following original certificate/
*Degree/Diploma granted by Diplomate of National Board Note:- The number of vacancies of all the above certificates in the prescribed format, when asked for by the
(DNB) bodies for the concerned specialty(ies) mentioned mentioned posts may increase/decrease depending Commission. If the certificates are not submitted in time,
above shall also be eligible subject to the rules above. upon the circumstances/requirements. the candidature shall be cancelled.
*Holders of Postgraduate degree/Postgraduate diploma GENERAL INSTRUCTIONS 15.1 Only Higher Secondary/High School Certificate for
issued by the Medical Council of India, institutions recognized proof of the age shall be treated valid.
by National Medical Commission and Diplomate of National LAST DATE FOR SUBMISSION OF ONLINE
15.2 Proof of degree/diploma or its equivalent qualifications
Board-DNB will only be eligible for this selection process, apart APPLICATION : 16.04.2024 to confirm the prescribed essential and preferential
from the said institutions, Postgraduate degree/ Postgraduate LAST DATE FOR THE PAYMENT OF qualifications.
diploma issued by any other institution will not be valid. APPLICATION FEE IN THE BANK : 12.04.2024 15.3 In the case of physically handicapped candidates, the
Note:- Candidates should be Registered in U.P. Medical 1.The candidate must carefully study the detailed certificate issued by the competent authority in the format-1
Council or N.M.C.. advertisement and may apply for the post only when he/ she to the Govt. Order No. 05/2022/18/1/2008/47/ka-2/2022
Relevant Service Rules of the post is eligible for the concerned post. dated 18th April 2022.
* The Uttar Pradesh Medical and Health Service Rules, 2020 2. Applications after the last prescribed date and time will not 15.4 In the case of the skilled players of the classified
* The Uttar Pradesh Medical and Health Service (First be accepted under any circumstances. Incomplete and sports, a certificate issued by the competent authority will
Amendment) Rules, 2021 ambiguous application forms will be cursorily rejected even if be required in termsthof the Government Order No. – 22/21/
* vij eq[; lfpo] fpfdRlk LokLF; ,oa ifjokj dY;k.k] mRrj izns'k 'kklu received on time. 1983-Ka-2 dated 28 November 1985.
}kjk egkfuns'kd] fpfdRlk ,oa LokLF; lsok;sa] mRrj izns'k dks izsf"kr i= 3. The knowledge of Hindi is essential. 15.5 Under any reserved category/categories, for the
la[;k & 3645@lsd&2&ikap&2020&vkj&14@2020] fnukad 18-12-2020 esa 4. The date of calculation of age (except where indicated confirmation of the claim for reservation, the caste
mfYyf[kr ^^m0iz0 fpfdRlk ,oa LokLF; lsok fu;ekoyh] 2020^^ ds iz[;kiu otherwise) is 1st July, 2024. The maximum age-limit shall be certificate issued by District Magistrate/Additional District
o fu;ekoyh ds laca/k esa laxr fn'kk& funsZ'k@ekxZn'khZ fl)kar@fu.kZ;A relaxable by five years for the candidates belonging to Magistrate (Executive)/City Magistrate/SDM/Tehsildar in the
Prohibition Department (Social Welfare), U.P. Scheduled Caste, Scheduled tribe, Other backward class, prescribed format prescribedndunder Govt. Order No. 22/16/92-
Name of Post- Prohibition and Social Uplift Officer, Number Skilled players of U.P. of Classified games (for the post of TC-III/Ka-2/2002 dated 22 October, 2008 in respect of
of Post- Total-01 Post (Unreserved), Nature of Post- Group Group 'B' and 'C' only) (Only domiciled persons of U.P. are candidates belonging to the SC/ST/OBC, will be accepted .
'B' Gazetted, Deptt. No.- S-4/01, Reservation- As per entitled for such age relaxation) and State Govt. Employees 15.6 mRrj izns'k 'kklu] dkfeZd vuqHkkx&2 ds i=kad 1@2019@
existing rules, Pay Scale- Level-7, Pay scale (minimum): of U.P. including Teachers/ Staff of the Basic Shiksha 4@1@2002@dk&2@19 Vh-lh-&AA fnukad 18 Qjojh 2019 esa fufgr
44900, Pay scale (maximum): 142400 Earlier Pay Band-2 Parishad of U.P. according to G.O. No. 1648/79-5-2015, izkfo/kkuksa ds vuqikyu esa mRrj izns'k jkT; ds ewy fuoklh ,oa vkfFkZd :i
Rs. 9300-34800 Grade Pay-4600, Age- 21 to 40 years (Age dated 19 June, 2015 and Teachers/Staff of the Government ls detksj oxksZa ds ,sls O;fDr;ksa tks vuqlwfpr tkfr] vuqlwfpr tutkfr
relaxation is permissible as per rules). (A) Academic Aided Madhyamik Vidyalayas of U.P. as per G.O. No. rFkk vU; fiNM+s oxksZa ds fy, vkj{k.k dh orZeku O;oLFkk ls vkPNkfnr ugha
Qualification- candidate for direct recruitment to the service 1508/15-8-2015-3057, dated 16 September, 2015. The upper
must posses a Bachelors degree with Economics and age limit shall also be greater by 3 years + period of service gSa] dks mRrj izns'k ljdkj dh yksd lsokvksa vkSj inksa dh lHkh Jsf.k;ksa esa
Sociology of a recognized University and must also possess a rendered in army for the emergency commissioned lh/kh HkrhZ ds izØe ij 10 izfr'kr dk vkj{k.k fu;ekuqlkj ns; gksxkA
good knowledge of Hindi in Devnagri script: Provided that officers/short service commissioned officers/Ex-Army 15.7 Those candidates, willing to take the benefit of the
preference will be given to candidates who possess one or personnels of U.P. It is essential to be discharged from army upto reservation may obtain a certificate, issued by the
more of the following qualifications: (I) Master's or Higher Degree the last date of receipt of application. Relaxation of 15 years in competent authority, in support of the reserved category, in
in Economics or Sociology or Social Welfare; (ii)Arecognised the upper age limit will be admissible to P.H. candidates. the prescribed format printed in this detailed advertisement

Page-2
and submit the same to the Commission, whenever required to
do so. Those candidates claiming the concession of more than
one reserved category will be given only one such benefit, which
will be more beneficial. The candidates not originally domiciled in
U.P. belonging to SC, ST, O.B.C., dependants of freedom
fighters, physically handicapped and Ex-servicemen are not
entitled to the benefit of reservation. Such candidates should
apply in general category. In case of women candidates, the
caste certificate issued from father side will be treated valid.
uksV%& ¼1½ måçå ds lekt ds fnO;kax vH;fFkZ;ksa ds fy;s 'kklu }kjk
vf/klwfpr ¼fpfUgr½ fd;s x;s inksa ij p;u ds laca/k esa tkjh dk;kZy;
Kki laå&5@2022@18@1@2008@47@dk&2@2022] fnukad&18 vçSy
2022 ds fcUnq&5¼vukjf{kr fjfä;ksa ij fu;qfä½ esa çkfo/kku fuEukuqlkj
fd;k x;k gS& fnO;kaxrk ls xzLr O;fä;ksa ds fy;s mi;qä fpfUgr fd;s
x;s inksa esa] fnO;kaxrk ls xzLr O;fä dks fdlh vukjf{kr fjfä ij fu;qfä
ds fy;s çfrLi/kkZ djus ls euk ugh fd;k tk ldrk gS vFkkZr fnO;kaxrk ls
xzLr O;fä dks fdlh vukjf{kr fjfä ij fu;qä fd;k tk ldrk gS c'krsZ
fd in laxr Js.kh dh fnO;kaxrk ls xzLr O;fä;ksa ds fy;s fpfUgr fd;k x;k
gksA 'kklukns'k la[;k&39 fjV@dk&2@2019 fnukad & 26 twu] 2019 }kjk
'kklukns'k la[;k& 18@1@99@dk&2@2006 fnukad 09 tuojh] 2007 ds
çLrj&4 esa fn;s x;s çkfo/kku] ^^;g Hkh Li"V fd;k tkrk gS fd jkT;k/khu yksd
lsokvksa vkSj inksa ij lh/kh HkrhZ ds çØe ij efgykvksa dks vuqeU; mijksä
vkj{k.k dsoy mÙkj çns'k dh ewy fuoklh efgykvksa dks gh vuqeU; gS** dks fjV
;kfpdk la[;k&11039@2018 fofiu dqekj ekS;kZ o vU; cuke mÙkj çns'k
jkT; o vU; rFkk lEc) 6 vU; fjV ;kfpdkvksa esa ekå mPp U;k;ky;]
bykgkckn }kjk fnukad 16-01-2019 dks vf/kdkjkrhr ¼Ultra Vires) ?kksf"kr
djus lEcU/kh fu.kZ; ds vuqikyu esa 'kklukns'k fnukad 09-01-2007 ls
çLrj&04 dks foyksfir fd, tkus dk fu.kZ; fy;k x;k gSA mä fu.kZ;
'kklu }kjk ekå mPp U;k;ky; ds vkns'k fnukad 16-01-2019 ds fo:) nk;j
fo'ks"k vihy ¼Mh½ la[;k&475@2019 esa ekå U;k;ky; }kjk ikfjr gksus okys
vfUre fu.kZ; ds v/khu gksxkA
16. The candidates of reserved categories will be adjusted
against the unreserved category in the final selection only if
he/she has not availed any benefit/ concession in qualifying
standard at the stage of Screening Examination.
17. The Commission do not advise to candidates about their
eligibility. Therefore, they should carefully read the
advertisement and apply only when satisfied about their
qualifications in terms of the advertisement.
18. In the category of dependents of the freedom fighters
only sons, daughters, grand-sons (son's son/daughter's son)
and grand daughters (son's daughter/daughter's daughter,
married/ unmarried) are covered. Only such relationships with
the freedom fighters are not adequate but the candidate should
remain actually dependent of the freedom fighter. It is advised
that now the candidates may obtain the reservation, certificate
from the District Magistrate in terms of Govt. Order No. 453/79-
V-1-15-1(Ka)/14-2015 dated 07-04-2015 in the prescribed
format and submit the same.
19. In the event of involvement of a candidate in the
concealment of any important information, pendency of any
case/criminal case, conviction, more than a husband or wife
being alive, submission of facts in a distorted manner,
canvassing for selection etc. The Commission reserves the
right to reject the candidature and debar from appearing in
the examinations and selections.
20. Be sure to mention the name of Post applied for,
advertisement number, department number, date of birth, O.T.R.
No. andApplication ID for correspondence with the Commission.
21. Candidates are required to hold essential qualification till
the last date of receipt of On-line application.
22. If any change is to be made in the personal detail
mentioned in the O.T.R, it will be mandatory to Synchronize it on
the Dashboard after the change. Otherwise change will not be
allowed. No representation will be accepted for error
correction/amendment in this regard. Incomplete application
will be cursorily rejected and no correspondence will be
entertained in this regard. Submission of false/misleading
information will lead to cancellation of candidature.
23. The candidates whose candidature are cancelled, those
candidates do not remain candidates after the cancellation of
candidature, therefore the marks of such candidates shall not be
provided.
24. In case the candidates feel any problem in the "On-line
Application" they may get their problem resolved by sending their
quarries to the 'Mail Box' of the Commission.
Detailed Application Form:
At the online page there is a 'Declaration' for the
candidates. Candidates are advised to go through the contents
of the Declaration carefully. Candidate has the option to either
agree or disagree with the contents of Declaration by clicking
on 'I Agree' or 'I do not agree' buttons. In case the candidate
opts to 'I do not agree', the application will be dropped and
the procedure will be terminated. Accepting to 'I Agree' only
will make possible the submission of the candidate's Online
Application.
Notification Details
This section shows information relevant to Notification i.e.
Notification number, selection type, directorate/department
name and post name
Personnel Details from OTR
This section shows information about candidate
personnel details i.e. OTR Number, candidate name,
Father/Husband name, Gender, DOB, UP domicile, Category,
Marital status, email and contact number, photo & signature,
address, UP Freedom Fighter, Ex Army, service duration and
your physical challenges, Skilled Player, Outstanding Player
of U.P., Debarred candidate.
Education & Experience Details
It shows your educational and experience details
Declaration segment
At the online page there is a 'Declaration' for the
candidates. Candidates are advised to go through the contents
of the Declaration carefully.
After filling all above particulars there is provision for
preview your detail before final submission of application form on
clicking on “Preview” button.
Preview page will display all facts/particulars that you
have mentioned in O.T.R. if you are sure with filled details then
click on “Submitt” button to finally push data into server with
successful submission report that you can print.
gLrk{kj ------------------¼dk;kZy; dk eqgj lfgr½
[CANDIDATES ARE ADVISED TO TAKE A PRINT OF vkosnd dk
THIS PAGE BY CLICKING ON THE “Print” OPTION iwjk uke ------------------------------------------------------------------
ikliksVZ lkbt
AVAILABLE] inuke --------------------------------------------------------------------
dk vfHkizekf.kr
For other information candidates are advised to select ftykf/kdkjh@vfrfjDr ftykf/kdkjh@flVh
desired option in 'Home Page' of Commission's website QksVksxzkQ
eftLVªVs @ijxuk eftLVªVs @rglhynkjA
https://uppsc.up.nic.in
IMPORTANT ANNOUNCEMENT ¼çi=&II½
:- NOTIFICATIONS / ADVERTISEMENTS vkfFkZd :i ls detksj oxZ ds ykHkkFkZ Lo;a ?kks"k.kk i=
?All Notification / Advertisements Lo;a ?kks"k.kk i=
:- ONLINE APPLICATION FORMS SUBMISSION eSa ------------------ iq=@iq=h@iRuh ---------------- xzke@dLck ------------------ iksLV
?Candidate Registration
vkWfQl ----------------------- Fkkuk ------------------- Cykd ------------------ rglhy ----------------------
?Fee Deposition /Reconciliation
ftyk ----------------------- jkT; ----------------------------------- us vkfFkZd :i ls detksj oxZ
?Submit Application Form
?Modify Submitted Application
ds çek.k i= gsrq vkosnu fn;k gS] ,rn~ }kjk ?kks"k.kk djrk@djrh gw¡A
?Candidate Dashboard (OTR Based) 1. eSa -------------------------------------------- tkfr ls lEcU/k j[krk@j[krh g¡]w tks
:- CANDIDATE'S HELP DESK SECTION mRrj izn's k gsrq vf/klwfpr vuqlfw pr tkfr] vuqlfw pr tutkfr] ,oa vU;
?Double Verification mode fiNM+k oxZ dh lwph esa lwphc) ugha gSA
?View Application Status 2- esjs ifjokj dh dqy Jksrksa ¼osru] d`f"k] O;olk;] is'kk bR;kfn½ ls
?Download Admit Card dqy okf"kZd vk; : ------------------------ ¼'kCnksa es½a gSA
?Print Duplicate Registration Slip
3- esjs ifjokj ds ikl mfYyf[kr vk; ds flok; vFkok blds
?Print Detailed Application Form
?List of Applications Having ANY Objections
vfrfjDr vU;= dksbZ ifjlEifRr ugha gSA
vFkok
?View Answer Key
dbZ LFkkuksa ij fLFkr ifjlEifRr;ksa dks tksMu+ s ds i'pkr Hkh eSa
LAST DATE FOR RECEIPT OF APPLICATIONS : On-line
Application process must be completed (including filling up ¼uke½ --------------------------------- vkfFkZd :i ls detksj oxZ ds nk;js esa
of OTR, Part-I, Part-II and Part-III of the Form) before last vkrk@vkrh g¡Aw
date of form submission according to Advertisement, after 4- eSa ?kks"k.kk djrk@djrh g¡w fd esjs ifjokj dh lHkh ifjlEifRr;ksa
which the web-link will be disabled. dks tksMu+ s ds i'pkr~ fuEufyf[kr esa ls fdlh Hkh lhek ls vf/kd
ifjf'k"V ugha gSA
m0iz0 dh vuqlwfpr tkfr rFkk vuqlwfpr tutkfr ds fy;s tkfr I. 5 ¼ikWp a ½ ,dM+ d`f"k ;ksX; Hkwfe vFkok mlls ÅijA
izek.k&i= ¼izk#i&II½ II. ,d gtkj oxZ QhV vFkok blls] vf/kd {ks=Qy dk ¶ySVA
izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh -------------------------lqiq=@ lqiq=h III. vf/klwfpr uxjikfydk ds varxZr 100 oxZ xt vFkok blls
Jh ---------------------- fuoklh ----------------- xzke ------------------- rglhy --------------------- uxj vf/kd dk vkoklh; Hkw[k.MA
------------------------ ftyk -------------------------- mRrj izns'k jkT; dh ----------------------- tkfr IV. vf/klwfpr uxjikfydk ls brj 200 oxZ xt vFkok blls
ds O;fDr gSa ftls lafo/kku ¼vuqlfw pr tkfr½ vkns'k] 1950 ¼tSlk fd le;& le; vf/kd dk vkoklh; Hkw[k.MA
ij la'kksfèkr gqvk½@lafo/kku ¼vuqlwfpr tutkfr] mRrj izns'k½ vkns'k] 1967 eSa çekf.kr djrk@djrh gw¡ fd esjs }kjk mijksDr tkudkjh esjs Kku vkSj
ds vuqlkj vuqlfw pr tkfr@vuqlfw pr tutkfr ds :i esa ekU;rk nh xbZ gSA fo'okl ds vuqlkj lR; gS vkSj eSa vkfFkZd :i ls detksj oxZ ds fy,
Jh@Jherh@dqekjh ------------------------------------ rFkk@vFkok mudk ifjokj vkj{k.k lqfo/kk çkIr djus gsrq ik=rk /kkj.k djrk@djrh gw¡A ;fn esjs }kjk
mRrj izns'k ds xzke ---------------------- rglhy ---------------------- uxj ------------------------- nh xbZ tkudkjh vlR;@xyr ik;h tkrh gS rks eSa iw.kZ :i ls tkurk
ftyk ---------------------- esa lkekU;r;k jgrk gSA gw¡W@tkurh gw¡ fd bl vkosnu i= ds vk/kkj ij fn;s x;s çek.k i= ds }kjk
LFkku -------------------------- gLrk{kj--------------------------- 'kS{kf.kd laLFkku esa fy;k x;k ços'k@yksd lsokvksa ,oa inksa esa izkIr dh xbZ
fnuakd ----------------------- iwjk uke-------------------------- fu;qfDr fujLr dj nh tk;sxh@dj fn;k tk;sxk vFkok bl çek.k i= ds
vk/kkj ij dksbZ vU; lqfo/kk@ykHk çkIr fd;k x;k gS mlls Hkh oafpr fd;k
eqgj --------------------------- in uke----------------------------
tk ldsxk vkSj bl lEcU/k esa fof/k ,oa fu;eksa ds v/khu esjs fo:) dh tkus
ftykf/kdkjh@vfrfjDr ftykf/kdkjh@flVh eftLVs ª V @ijxuk okyh dk;Zokgh ds fy, eSa mRrjnk;h jgw¡xk@jgw¡xhA
eftLVsªV@rglhynkj@vU; osru Hkksxh eftLVsªV] ;fn dksbZ gks@ ftyk
uksV%& tks ykxw ugha gks mls dkV nsAa
lekt dY;k.k vf/kdkjhA
mÙkj izns'k ds vU; fiNM+s oxZ ds fy, tkfr izek.k&i=
LFkku %& vkosnd@vkosfndk dk gLrk{kj rFkk iwjk ukeA
¼izk#i&I½
Form-II
izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ------------------ lqiq=@ lqiq=h -----
Certificate of Disability
------------- fuoklh ------------------ rglhy ------------------ uxj ------------- ftyk -----------------
(In cases of amputation or complete permanent paralysis of
mRrj izns'k jkT; dh -------------------- fiNM+h tkfr ds O;fDr gSaA ;g tkfr m0iz0
limbs or dwarfism and in case of blindness) (Name and
yksd lsok ¼vuqlwfpr tkfr;ksa] vuqlwfpr tutkfr;ksa vkSj vU; fiNM+s oxksZa ds Address of the Medical Authority issuing the Certificate)
fy;s vkj{k.k½ vf/kfu;e] 1994 ¼;Fkkla'kksf/kr½ dh vuqlwph&,d ds vUrxZr
ekU;rk izkIr gSA Recent passport size
;g Hkh izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh --------------- attested photograph
iwoksZDr vf/kfu;e] 1994 ¼;Fkkla'kksf/kr½ dh vuqlwph&nks tSlk fd m0iz0 (showing face only) of
yksd lsok ¼vuqlwfpr tkfr;ksa] vuqlwfpr tutkfr;ksa vkSj vU; fiNM+s oxksZa ds the person with disabiliy
fy;s vkj{k.k½ ¼la'kks/ku½ vf/kfu;e] 2001 }kjk izfrLFkkfir fd;k x;k gS ,oa Certificate No. Date:
tks m0iz0 yksd lsok ¼vuqlwfpr tkfr;ksa] vuqlwfpr tutkfr;ksa vkSj vU; This is to certify that I have carefully examined
fiNM+s oxksZa ds fy;s vkj{k.k½ ¼la'kks/ku½ vf/kfu;e] 2002 }kjk la'kksf/kr dh Shri/Smt./Kum. _____________ son/wife/daughter of
x;h gS] ls vkPNkfnr ugha gSA buds ekrk&firk dh fujarj rhu o"kZ dh vof/k Shri__________ Date of Birth (DD/MM/YY) ________ Age
ds fy;s ldy okf"kZd vk; vkB yk[k #i;s ;k blls vf/kd ugha gS rFkk ____ years, male/female ___________ registration No.
buds ikl èkudj vf/kfu;e] 1957 esa ;Fkk fofgr NwV lhek ls vf/kd
__________ permanent resident of House No. ________
lEifRr Hkh ugha gSA Ward/Village/Street _________Post office_________
Jh@Jherh@dqekjh ------------------------------- rFkk@vFkok mudk ifjokj District________State__________.
mRrj izns'k ds xzke ----------------------- rglhy ---------------------- uxj ------------------------ whose photograph is affixed above, and am satisfied that:
ftyk ------------------------ esa lkekU;r;k jgrk gSA he/she is a case of:
LFkku -------------------------- gLrk{kj ----------------------------- n Iocomotor disability
fnuakd ----------------------- iwjk uke ----------------------------- n dwarfism
eqgj --------------------------- in uke ----------------------------- n blindness
ftykf/kdkjh@vfrfjDr ftykf/kdkjh@flVh eftLVsªV@ijxuk eftLVsªV@ (Please tick as applicable)
rglhynkjA (B) The diagnosis in his/her case is_________
¼çi=&I½ (A) he/she has ________% (in figure)________percent
(in words) permanent locomotor disability/
mRrj çns'k ljdkj
dk;kZy; dk uke---------------------------------------------- dwarfism/blindness in relation to his/her______ (part
of body) as per guidelines (.............number and date
vkfFkZd :i ls detksj oxZ ds lnL; }kjk izLrqr fd;k tkus
of issue of the guidelines to be specified).
okyk vk; ,oa ifjlEifRr izek.k&i=
2. The applicant has submitted the following document
çek.k i= la[;k------------------- fnukad -------------------- as proof of residence:-
foRrh; o"kZ ---------------- ds fy, ekU;
Nature of Date of Details of authority
çekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh------------------------------ iq=@ Document Issue Issuing certificate
ifr@iq=h----------------------------------- xzke@dLck---------------------------- iksLV vkWfQl -------
--------------------- Fkkuk ------------------------------ rglhy ---------------------------- ftyk ------------------
--------- jkT; --------------------- fiu dksM -------------------- ds LFkk;h fuoklh gS]a ftudk 3. Signature and seal of the Medical Authority.
QksVksxkz Q uhps] vfHkçekf.kr gS] vkfFkZd :i ls detksj oxZ ds lnL; gS]a D;ksfa d (Dr...............) (Dr...............) (Dr...............)
foRrh; o"kZ -------------------- esa buds ifjokj dh dqy okf"kZd vk; 8 yk[k ¼vkB yk[k Member Member Chairperson
:i;s ek=½ ls de gSA buds ifjokj ds LokfeRo esa fuEufyf[kr esa ls dksbZ Hkh Medical Board Medical Board Medical Board
ifjlEifRr ugha gS%& with seal with seal with seal
I. 5 ¼ikWpa ½ ,dM+ d`f"k ;ksX; Hkwfe vFkok mlls ÅijA
II. ,d gtkj oxZ QhV vFkok blls] vf/kd {ks=Qy dk ¶ySVA Countersigned by the
III. vf/klwfpr uxjikfydk ds varxZr 100 oxZ xt vFkok blls Chief Medical Officer
vf/kd dk vkoklh; Hkw[k.MA (with seal)
IV. vf/klwfpr uxjikfydk ls brj 200 oxZ xt vFkok blls vf/kd Form-III
dk vkoklh; Hkw[k.MA Certificate of Disability
(In cases of multiple disabilities)
2- Jh@Jherh@dqekjh -------------------------------------- tkfr ------------------- ds lnL;
gSa tks vuqlfw pr tkfr] vuqlfw pr tutkfr rFkk vU; fiNM+s oxksZa ds :i esa (Name and Address of the Medical Authority/Board
vf/klwfpr ugha gSAa issuing the Certificate)
Page-3
 Signature/thumb Recent passport size Shri/Smt./Kum.___________son/wife/daughter of izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ------------------------
impression of the person in attested photograph Shri _____________ Date of birth (DD/MM/ YY) _______ vkRet@iRuh@vkRetk Jh --------------------- fuoklh ---------------------- iwjk
whose favour certificate of (showing face only) of age_____ years, male/ female__________. irk ----------------- us fnukad --------------- ls fnukad ------------------ rd ---------
disability is issued the person with disabiliy Registration No.__________permanent resident of House --------------------------- ¼LFkku dk uke½ esa vk;ksftr----------------------------------------
Certificate No. Date: No. ________ Ward/Village/ Street________Post
¼ØhM+k@[ksy&dwn dk uke½ dh izfr;ksfxrk@VwukZesUV esa ns'k dh
This is to certify that we have carefully examined Office_______District________ State_______, whose
vksj ls Hkkx fy;kA
Shri/Smt./Kum.___________son/wife/ daughter of photograph is affixed above, and am satisfied that he/she is
a case of ___________ Disability. His/her extent of
muds Vhe ds }kjk mDr izfr;ksfxrk@VwukZesUV esa -----------------------------
Shri _____________ Date of birth (DD/MM/ YY) _______
age_____ years, male/ female__________. percentage physical impairment/disability has been LFkku izkIr fd;k x;kA
Registration No.__________ permanent resident of House evaluated as per guidelines (......number and date of issue ;g izek.k&i= jk"Vªh; QsMjs'ku@jk"Vªh; ,lksfl,'ku@¼;gk¡
No._________ Ward/Village/Street ________ Post Office of the guidelines to be specified) and is shown against the laLFkk dk uke fn;k tk;s½ --------- esa miyC/k fjdkMZ ds vk/kkj ij
_______ District ________ State _______, whose relevant disability in the table below fn;k x;k gSA
photograph is affixed above, and am satisfied that: LFkku -------------------------- gLrk{kj --------------------------------------
(A) he/she is a case of Multiple Disability. His/her extent of Permanent fnuakd ----------------------- uke ---------------------------------------------
Affected physical in -----------------------------------------------
Permanent S. part of Diagno impairment/ laLFkk dk uke ---------------------------
Affected physical N. Disability sis mental disability
S. Diagno body eqgj --------------------------------------------
part of impairment/
Disability sis mental disability (in%)
N. body uksV % ;g izek.k&i= us'kuy QsMjs'ku@us'kuy ,lksfl,'ku ds
(in%) 1. Locomotor disability @ lfpo }kjk O;fDrxr :i ls fd;s x;s gLrk{kj gksus ij gh ekU;
1. Locomotor disability @ 2. Muscular Dystrophy gksxkA
2. Muscular Dystrophy 3. Leprosy cured izk:i & 2
3. Leprosy cured 4. Cerebral Palsy ¼ekU;rk izkIr ØhM+k@[ksy esa vius izns'k dh vksj ls jk"Vªh;
4. Dwarfism
5. Acid attack Victim
izfr;ksfxrk esa Hkkx ysus okys f[kykM+h ds fy;s½
5. Cerebral Palsy lEcfU/kr [ksy dh izns'kh; ,lksfl,'ku dk uke -------------------jkT;
6. Low Vision #
6. Acid attack Victim ljdkj dh lsokvksa@inksa ij fu;qfDr ds fy, dq'ky f[kykfM+;ksa
7. Deaf £ ds fy, izek.k&i=
7. Low Vision # 8. Hard of Hearing £ izekf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ---------------- vkRet@
8. Blindness # 9. Speech and iRuh@vkRetk Jh ----------------------- fuoklh ¼iwjk irk½ -----------------------us
9. Deaf £ Language disability fnukad----------------ls fnukad-------------------rd-------------------esa ¼ØhM+k@
10. Hard of Hearing £
10. Intellectual Disability
[ksy&dwn dk uke½ dh izfr;ksfxrk ¼VwukZesUV LFkku dk uke½-----------------
11. Speech and ---vk;ksftr jk"Vªh;--------------- esa ¼ØhM+k@[ksy&dwn dk uke½ dh
11. Specific Learning
Language disability Disability
izfr;ksfxrk@ VwukZesUV esa izns'k dh vksj ls Hkkx fy;kA
12. Intellectual Disability 12. Autism Spectrum
muds Vhe ds }kjk mDr izfr;ksfxrk@VwukZesUV esa -------------------------
13. Specific Learning
LFkku izkIr fd;k x;kA
Disorder
Disability ;g izek.k&i= ------------------------------------- ¼izns'kh; la?k dk uke½ esa
13. Mental illness
miyC/k fjdkMZ ds vk/kkj ij fn;k x;k gSA
14. Autism Spectrum
14. Chronic Neurological LFkku -------------------------- gLrk{kj --------------------------------------
Disorder Conditions fnuakd ----------------------- uke ---------------------------------------------
15. Mental illness 15. Multiple sclerosis in ---------------------------------------------
16. Chronic Neurological 16. Parkinson's disease laLFkk dk uke ---------------------------
Conditions 17. Haemophilia eqgj --------------------------------------------
17. Multiple sclerosis 18. Thalassemia uksV % ;g izek.k&i= izns'kh; [ksy&dwn la?k ds lfpo }kjk O;fDrxr
18. Parkinson's disease 19. Sickle Cell disease :i ls fd;s x;s gLrk{kj gksus ij gh ekU; gksxkA
19. Haemophilia
Please strike out the
çk:i & 3
20. Thalassemia disabilities which is not applicable)
¼ekU;rk iz k Ir ØhM+ k @[ks y esa vius fo'ofo|ky; dh vksj ls
21. Sickle Cell disease 2. The above condition is progressive/non-progressive/
vUrfoZ ' ofo|ky; iz f r;ks f xrk esa Hkkx ysus okys f[kykM+h ds fy;s½
permanent physical impairment/disability has bee evaluated likely to improve/not likely to improve. fo'ofo|ky; dk uke -------------------- jkT; Lrj dh lsokvksa@inksa
as per guidelines (......number and date of issue of the 3. Reassessment of disability is:- ij fu;qfDr ds fy, dq'ky f[kykfM+;ksa ds fy, izek.k&i=
guidelines to be specified) for the disabilities ticked below, (i) not necessary, or iz e kf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh ---------------------
and is shown against the relevant disability in the (B) In the (ii) is recommended/after............years............ vkRet@iRuh@vkRetk Jh ---------------------------- fuokl ¼iwjk uke½ ----------
light of the above, his/her over all permanent physical months, and therefore this certificate shall be ----------------------------- fo'ofo|ky; dh d{kk ---------------------------- ds fo|kFkhZ
impairment as per guidelines (.......number and date of issue valid till.... ...... ..... (DD) (MM) (YY) us fnuka d ----------------------- ls fnuka d --------------------- rd -----------------------
of the guidelines to be specified), is follows: @ - e.g. Left/right/both arms/legs ¼LFkku dk uke½ esa vk;ksftr vUrfoZ'ofo|ky; ----------------------------
In figures................percent. # - e.g. Single eye/both eyes ¼ØhM+k@ [ksy&dwn dk uke½ izfr;ksfxrk@VwukZesUV esa --------------------------
In words............................................................percent £ - e.g. Left/Right/both ears fo'ofo|ky; dh vksj ls Hkkx fy;kA muds Vhe ds }kjk mDr
2. This condition is progressive/non-progressive/likely to izfr;ksfxrk@VwukZesUV esa ------------------------- LFkku izkIr fd;k x;kA ;g
improve/not likely to improve. izek.k&i= Mhu vkWQ LiksV~lZ vFkok bapktZ [ksy dwn -----------------
3. Reassessment of disability is:- Name and Seal Name and Seal Name and Seal fo'ofo|ky; esa miyC/k fjdkMZ ds vk/kkj ij fn;k x;k gSA
(i) not necessary, of Member of Member of the Chairperson LFkku -------------------------- gLrk{kj --------------------------------------
or fnuakd ----------------------- uke ---------------------------------------------
(ii) is recommended/ after............ years............ months, Signature/thumb 4. Countersigned by the
in ----------------------------------------------
and therefore this certificate shall be valid till.... ...... ..... impression of the Chief Medical Officer
person in whose
laLFkk dk uke ---------------------------
(DD) (MM) (YY) (with seal) eqgj --------------------------------------------
@ -e.g. Left/right/both arms/legs favour certificate of Signature and seal of the
disability is issued Medical Authority. uks V % ;g iz e k.k&i= fo'ofo|ky; ds Mhu vkWQ LiksV~lZ ;k bapktZ
# - e.g. Single eye
[ksy&dwn }kjk O;fDrxr :i ls fd;s x;s gLrk{kj gksus ij gh ekU;
£ - e.g. Left/Right/both ears
4. The applicant has submitted the following document as mÙkj izns'k yksd lsok ¼'kkjhfjd :Ik ls fodykax] Lora=rk laxzke lsukfu;ksa gksxkA
proof of residence:- ds vkfJrksa vkSj HkwriwoZ lSfudksa ds fy;s vkj{k.k½] vf/kfu;e] 1993 izk:i & 4
¼;Fkkla'kksf/kr½ ds vuqlkj Lora=rk laxzke lsukuh ds vkfJr ds izek.k&Ik= ¼ekU;rk iz kIr ØhM+ k@[ks y esa vius Ldwy dh vksj ls jk"Vªh;
Nature of Date of Details of authority [ks y &dw n es a Hkkx ys us okys f[kykM+h ds fy;s½
Issue issuing certificate dk izi=A
Document MkbjsDVªsV vkWQ ifCyd bUlVªD'kUl@funs'kd] f'k{kk] mÙkj izns'k
izek.k&i=
izekf.kr fd;k tkrk gS fd Jh@Jherh ------------------------ fuoklh xzke& ---------------
------------------------------ jkT; Lrj dh lsokvksa@inksa ij fu;qfDr ds fy,
5. Signature and seal of the Medical Authority. uxj& ------------------- ftyk& ---------------- mÙkj izns'k yksd lsok ¼'kkjhfjd :Ik ls
dq'ky f[kykfM+;ksa ds fy, izek.k&i=
fodykax] Lora=rk laxzke lsukfu;ksa ds vkfJrksa vkSj HkwriwoZ lSfudksa ds fy;s vkj{k.k½
iz e kf.kr fd;k tkrk gS fd Jh@Jherh@dqekjh -------------------------------------
vkRet@iRuh@vkRetk Jh ------------------------------------------- fuoklh ¼iwjk
vf/kfu;e] 1993 ds vuqlkj Lora=rk laxzke lsukuh gSa vkSj Jh@Jherh@dqekjh
Name and Seal Name and Seal Name and Seal irk½ ------------------------------------ esa ----------------------------- Ldwy esa d{kk ---------------
¼vkfJr½ ----------- iq=@iq=h@ikS= ¼iq= dk iq= ;k iq=h dk iq=½ rFkk ikS=h ¼iq= dh iq=h
of Member of Member of the Chairperson ds fo|kFkhZ us fnukad ------------------- ls fnukad ------------------- rd ------------------
;k iq=h dh iq=h½ ¼fookfgr vFkok vfookfgr½ mijkafdr vf/kfu;e] 1993 ¼LFkku dk uke½ esa vk;ksftr Ldwyksa ds us'kuy xsEl dh ------------------------
Countersigned by the ¼;Fkkla'kksf/kr½ ds izkfo/kkuksa ds vuqlkj mDr Jh@Jherh ¼Lora=rk laxzke lsukuh½ ---- ¼ØhM+k@[ksy&dwn dk uke½ izfr;ksfxrk@VwukZesUV esa ---------------------------
Chief Medical Officer ------------ds vkfJr gSaA Ldwy dh vksj ls Hkkx fy;kA muds Vhe ds }kjk mDr izfr;ksfxrk@
(with seal) LFkku% gLrk{kj ----------------------------------- VwukZesUV esa ------------------------- LFkku izkIr fd;k x;kA
fnukad% iwjk uke ----------------------------------- ;g izek.k&i= MkbjsDVªsV vkWQ ifCyd bUlVªD'kUl@f'k{kk esa
inuke ------------------------------------- miyC/k fjdkMZ ds vk/kkj ij fn;k x;k gSA
Form-IV eqgj ------------------------------------------ LFkku -------------------------- gLrk{kj -------------------------------------
Certificate of Disability ftykf/kdkjh fnuakd ----------------------- uke ---------------------------------------------
(In cases of other than those mentioned in Forms ¼lhy½ in ----------------------------------------------
II and III ) dq'ky f[kykfM+;ksa ds fy;s izek.k&i= tks m-iz- ds ewy fuoklh gSa laLFkk dk uke --------------------------
(Name and Address of the Medical Authority/Board issuing 'kklukns'k la[;k&22@21@1983&dkfeZd&2 eqgj -------------------------------------------
the Certificate) fnukad 28 uoEcj] 1985 uksV % ;g izek.k&i= funs'kd@;k vfrfjDr@la;qDr ;k mifuns'kd
izek.k&i= ds QkeZ & 1 ls 4 MkbjsDVªsV vkWQ ifCyd bUlVªD'kUl@f'k{kk -------------------- }kjk
Recent passport size
izk:i &1 O;fDrxr :i ls gLrk{kj gksus ij ekU; gksxkA
attested photograph
¼ekU;rk izkIr ØhM+k@[ksy esa vius ns'k dh vksj ls vUrjkZ"Vªh; izfr;ksfxrk esa Secretary
(showing face only) of
Hkkx ysus okys f[kykM+h ds fy;s½
the person with disabiliy
lEcfU/kr [ksy dh jk"Vªh; QsMjs'ku@jk"Vªh; ,lksfl,'ku dk
Certificate No. Date: uke --------------------------- jkT; ljdkj dh lsokvksa@inksa ij fu;qfDr
This is to certify that we have carefully examined ds fy, dq'ky f[kykfM+;ksa ds fy, izek.k&i=

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