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Undertaking Mmlsay

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wahi.mustak
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22K views1 page

Undertaking Mmlsay

Uploaded by

wahi.mustak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
  • Undertaking Declaration

UNDERTAKING

I, Mustafizur Rahman, working as a 'Graduate Teacher (Science)' at Shawrachara M.K.


Higher Secondary School, Barpeta, do hereby undertake that I want to opt-out from 'Mukhya
Mantri Lok Sevak Arogya Yojana (MMLSAY)' scheme of the State Government of Assam. I don't
want to avail any benefits under this scheme.

REASON : Spouse has already availed MMLSAY Scheme and covered me as a dependent
along with nominee and have some financial problem.

Signature of Employee

Signature of DDO. Name : Mustafizur Rahman

Date : Desig.: Graduate Teacher (Science)

Office: Shawrachara M.K. H.S. School

Date : 05/02/2024

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