To

The Additional District Magistrate,

Angul.

Sub: - Request for cancellation of my name from Election duty due to health issues.

Respected Sir,
I, Suresh Chandra Dehury, Foreman I/C, Balram OCP, Hingula Area, Election EMP ID
No-21019772 am suffering from FRACTURE & DISLOCATION OF (RIGHT) HIP since 27-05-
2019 and PTCA+STENTING TO LCX problem since 16.07.2022. My treatment is undergoing at
AMRI HOSPITAL, BBSR. All medical documents are enclosed herewith for your kind reference.

With this condition, I will be unable to perform election duty, which would be in
May/June which would trigger my health issues.

Therefore, I would request you to kindly arrange to cancel my name from election duty and for
which I shall be thankful to you.

Dt. Yours Faithfully,

Encl:-
1.Appointment order of Election Duty
2.Medical Documents (Suresh Chandra Dehury)
Design- Foreman I/C,
Balram OCP, Hingula Area, MCL
UM No - 77066579
EMP ID – 21019772
Mob No- 9437548268
Copy to:-
The Sub-Collector, Talcher