NIT PATNA RECRUITMENT 2022: 19 TECHNICAL ASSISTANT POSTS APPLY ONLINE
NIT: నిట్‌-పట్నాలో 19 టెక్నికల్‌ అసిస్టెంట్‌ ఖాళీలు
భారత ప్రభుత్వ రంగ సంస్థ అయిన పట్నాకు చెందిన నేషనల్‌ ఇన్‌స్టిట్యూట్‌ ఆఫ్‌ టెక్నాలజీ(నిట్‌) కింది పోస్టుల భర్తీకి దరఖాస్తులు కోరుతోంది.
వివరాలు…
* మొత్తం ఖాళీలు: 19
* టెక్నికల్‌ అసిస్టెంట్‌ పోస్టులు.
అర్హత: బీఈ/ బీటెక్‌/ బీఆర్క్‌/ బీఎస్సీ/ ఎంసీఏ/ ఇంజినీరింగ్‌ డిప్లొమా/ బీఎస్సీ/ మాస్టర్స్‌ డిగ్రీ ఉత్తీర్ణత.
వయసు: 30 ఏళ్లు మించకూడదు.
జీతభత్యాలు: నెలకు రూ.34800 వరకు చెల్లిస్తారు.
ఎంపిక విధానం: స్క్రీనింగ్‌, షార్ట్‌లిస్టింగ్‌
ప్రాసెసింగ్‌ ఫీజు: రూ.400
ఆన్‌లైన్‌ ఫీజు చెల్లించేందుకు చివరి తేది: 01.10.2022
ఆన్‌లైన్‌ దరఖాస్తు చివరి తేది: 03.10.2022
ఆఫ్‌లైన్‌ దరఖాస్తు చివరి తేది: 10.10.2022
OFFICIAL NOTIFICATION CLICK HERE
OFFICIAL WEBSITE CLICK HERE
JOIN OUR TELEGRAM CLICK HERE
NATIONAL INSTITUTE OF TECHNOLOGY PATNA
(An Institute of National Importance under Ministry of Education, Govt. of India)
ASHOK RAJPATH, PATNA-800 005 (BIHAR)
 |
Advertisement No: NITP/Rect./04/2022
Applications in the prescribed format are invited from Indian Nationals for recruitment to the following posts on regular basis at National Institute of Technology Patna, Ashok Rajpath, Patna-800 005.
|
Sr. No. |
Name of the Post |
No. of Post |
Category |
Pay Band & Grade Pay |
|
01. |
Technical Assistant |
19 |
UR -08 EWS -01 OBC(NCL) -05 SC -03 ST -01 PwD -01 |
Pay Level 6 of 7th CPC PB-2 (₹ 9,300-34,800/-) Grade Pay ₹ 4,200/- |
The candidates are required to submit the application and requisite fee through online portal only (www.nitp.ac.in). The online portal shall remain open from 16 th S e p t e m b e r 2 0 2 2 t o 3 rd O c t o b e r 2 0 2 2 . After successful online submission of application a print out of the application form along with self-attested supporting documents and proof of payment is to be sent to the Registrar, National Institute of Technology Patna, Ashok Rajpath, Patna 800 005, by speed-post / registered post only so as to reach on or before 10 th O c t o b e r 2 0 2 2 up to 5.00 PM. Before submission of online form the candidates are advised to carefully read the “Instructions for online submission of form” available on the online portal and “General Instructions to the Candidate” enclosed herewith.
IMPORTANT DATES:
|
1. |
Opening date for submission of online application |
16th September 2022 |
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2. |
Last date of submission of online fee |
01st October 2022 |
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3. |
Last date for submission of online application |
03rd October 2022 |
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4. |
Last date of submission of print out of application along with supporting documents |
10th October 2022, 5:00 PM |
Registrar
Page 1 of 6
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Essential / Desirable Qualification, Age and Experience
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Essential qualifications, age etc. for the post of Technical Assistant is available at
Annexure-I.
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Trade / Branch / field of study category wise vacancy with educational/Desirable qualifications for Technical Assistant are available at Annexure-II.
Note:
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Number and nature of positions may change and vary at the time of selection / recruitment. The Institute reserves the right to fill or not to fill all the advertised positions or any position.
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All recruitment and pay-fixation shall be done only on the recommendations of the duly constituted Selection Committee. The decision of the Appointing authority shall be final.
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Age Limit / Relaxation :
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Maximum age limit for each post shall be as per Recruitment Rule-2019.
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Those employees who are presently working on ad-hoc / temporary / contractual
/outsource basis in NIT Patna will be given one time age relaxation equivalent to the number of years served at NIT Patna with the upper age limit up to 56 years. This is applicable for only those persons who were working with the Institute on the date of Notification of RR, i.e., 20.02.2019 and still continuing in service. The relaxation will be applicable only for participation in this regular recruitment process. No relaxation in qualification and experience will be allowed under any circumstances.
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Regular staff of NITs who are otherwise eligible, shall be allowed to participate in the selection process irrespective of age and percentage of marks. This will be applicable to the regular staff of NITs who were appointed before the date of implementation of RRs in NITs.
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Age relaxation for SC / ST / OBC(NCL) / PwD applicants shall be applicable as per the Central Government norms, on production of required certificate issued by the competent authority. No relaxation would be applicable to SC / ST / OBC(NCL) / PwD applicants applying for Unreserved vacancies.
SNo.
Category
Age Relaxation permissible
beyond the Upper age limit
01
SC/ST
5 years
02
OBC(NCL)
3 years
03
PwD(UR)
10 years
04
PwD(OBC(NCL))
13 years
05
PwD(SC)/ PwD(ST)
15 years
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Age limit and other eligibility conditions for the above positions shall be determined on the last date of submission of online application form i.e. 3rd October 2022.
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Processing Fee :
Applicants belonging to UR / EWS / OBC(NCL) category shall be required to pay non-refundable fee of Rs. 400.00 and applicants belonging to SC / ST category Rs.200.00, PwD category is exempted from the payment of Fee.
Applicants who have already applied and paid processing fees against our Institute ADVT. NITP/RECT/02/2022 DATED 24th February 2022, need not to make payment again. However, they must submit the TRANSACTION ID, DATE with further details on the online application form.
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Selection Criteria:
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Screening of online applications received may be done to restrict the number of candidates to be called for selection process. The Institute at its discretion may restrict the maximum number of candidates to be called for any stage of the selection process.
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List of shortlisted candidates to be called for the selection process will be published on the Institute website www.nitp.ac.in Such candidates may also be intimated on their registered email ID mentioned in the application form. No request for change of date / venue by individual candidates will be entertained under any circumstances.
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Documents / Certificate to be enclosed /produced:
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Matriculation /10th Standard or equivalent certificate indicating date of birth, or mark sheet of Matriculation / 10th Standard or equivalent issued by Central / State Board indicating date of Birth.
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Higher Secondary / Class XII (or equivalent) board marks sheet.
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Degree certificate along with mark sheets pertaining to all academic years as proof of educational qualification claimed.
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The SC/ST/EWS/ OBC(NCL)/PwD certificates in the prescribed proforma enclosed at ANEXURE – III to VIII and issued by the DOPT, Govt. of India vide letter No. F.No. 36028/1/2014-Estt.(Res) dated 3rd September, 2015 will only be accepted as sufficient proof in support of a candidates claim to belongs to SC / ST / OBC(NCL) / EWS / PwD. Certificate must be issued by the Competent authority as per proforma enclosed at Annexure- III to VIII.
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General Instruction to the Candidates:
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The candidates are required to apply through online with complete information and attachments. Candidates applying for more than one post are required to submit separate application form and fee. However, the candidates will be sole responsible if the test of two or more trades coincides with each other and Institute will not be responsible to conduct
separate test at any stage for the applicants who have applied for more than one trades.
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Applicants applying in response to this advertisement should satisfy themselves regarding their eligibility for the post applied for. They must fulfill eligibility criteria as on the closing date of applications.
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The candidates applying for more than one post are required to create more than one email ID.
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The detail process (SOP) for filling online application form will be available on the Institute website www.nitp.ac.in
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The applicant will be responsible for the authenticity of submitted information, other documents and photograph.
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The Institute will retain data of online applications received for non-shortlisted candidates only for three months after the completion of recruitment process.
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Appointment on the above mentioned posts may be made on regular / deputation/short term contract. In case of deputation, benefits will be given as per GOI norms.
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Applicants will be considered only for the posts applied for.
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The selection process may consist of Screening Test, written test(s) , skill test(s), MCQ Test etc.
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The Institute reserves the right to withdraw any advertised post(s) at any time without giving any reason. The number of positions may increase or decrease
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Mere eligibility will not entitle any candidate for being called for the written test(s)/ skill test(s). More stringent criteria may be applied for shortlisting the candidates to be called for written test(s) / skill test(s).
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Eligibility of a candidate and satisfaction of any other Short-listing criteria shall be considered as on the last date of the submission of online application
i.e. 3rd October 2022
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Relaxation in Age Limit: Age relaxation for SC / ST / OBC(NCL) / Ex-Servicemen / PwD applicants shall be as per Govt of India rules applicable for the autonomous Institutions. No relaxation would be applicable to SC/ST/OBC(NCL)/PwD applicants applying for Unreserved Vacancies.
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Those employees who are presently working on ad-hoc / temporary / contractual / outsource basis in NIT Patna will be given one time age relaxation equivalent to the number of years served at NIT Patna with the upper age limit up to 56 years. This is applicable for only those persons who were working with the Institute on the date of notification of RR, i.e, 20.02.2019 and still continuing in service. The relaxation will be applicable only for participation in this regular recruitment process only. No relaxation in qualification and experience will be allowed under any circumstances.
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Application fees once paid shall not be refunded under any circumstances.
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(a) Application after the last date, (b) incomplete in any respect and (c) any fresh paper/ enclosures after closing date, shall not be considered.
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Certificates in support of experience should be in proper format i.e. it should be on the organization’s letter head, bear the date of issue, specific period of
work (in DD/MM/YYYY format), name, designation and signature of the Administrative Authority/Owner of the organization along with his/her seal.
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The Institute shall verify the antecedents or documents submitted by a candidate at any time, at the time of appointment or during the tenure of the service. In case, it is detected that the documents submitted by the candidates are fake or the candidate has clandestine antecedents/background and has suppressed the said information, then his/her candidature / services shall be liable to be cancelled / terminated as the case may be.
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In case of any inadvertent mistake in the process of selection which may be detected at any stage even after the issue of appointment letter, the Institute reserves the right to modify/ withdraw/ cancel any communication made to the candidates.
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In case of any dispute/ambiguity that may occur in the process of selection, the decision of the Institute shall be final.
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Applicants who are in Government employment should route their applications through proper channel.
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Candidates should send self-attested copies of certificates and mark-sheets from matriculation onwards in support of their qualifications. Originals should not be sent along with the application but these must be produced at the time of joining, if selected.
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One recent (not earlier than three months from the date of application) colour passport size photograph with clear front view of the applicant without cap, scarf and sun glasses should be uploaded while filling the online application form. Identical extra colour passport size photograph as uploaded on the online application should be kept for providing the same at the time of verification or as required by the Institute.
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Applicants must carry at least one valid identity card with photograph, in original, i.e. driving Licence, Voter Card, Aadhar Card, Identity Card issued by University /College / Institute to the examination centre, failing which he / she will not be allowed to appear for the examination.
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Candidates are advised to satisfy themselves before applying that they possess at least the minimum essential qualifications laid down in the advertisement.
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It will be the sole responsibility of the applicant to furnish correct information in the application form.
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Mere allowing to appear in the written test doesn’t mean that the applicant fulfils the eligibility criteria.
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No correspondence will be entertained from candidates regarding postal delays, conduct and result of test and reasons for not being called for test / further process.
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Canvassing in any form will be a disqualification.
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No interim correspondence shall be entertained.
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The posts carry retirement/terminal benefits as per GOI rules. Applicability of New Pension Scheme 2004 will be as per GOI rules. SC / ST / OBC(NCL) / EWS candidates are required to attach the valid caste / category certificate as
per format prescribed by the GOI. In case an OBC(NCL) candidate applies for reserved post under OBC(NCL) category, he/she must produce a valid certificate issued from the Competent Authority that he/she does not belong to anyone of the Creamy Layers. The Institute follows the Central List in the cases of SC / ST and OBC(NCL)s.
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The Institute reserves its right to place a reasonable limit on the total number of candidates to be called for test. The shortlisting criteria will be displayed on the Institute website.
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The information regarding written test will be furnished on the website of the Institute. No separate letter will be sent by post/email for this purpose. Further, for updates, please visit the Institute website regularly, as any subsequent amendment will be announced on the Institute website only.
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All the appointments are subject to verification of caste certificates, credentials, academic qualification, experience, conduct, medical fitness followed by police verification of the selected applicants. During the period of Institute service, if the Institute, on its verification, finds any discrepancy in the claims made by the applicant, besides departmental proceedings, suitable legal action shall also be initiated as per Government of India Rules.
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No T.A./D.A. will be paid for appearing in the test.
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Incomplete application or without application fee or without relevant supporting enclosures will be out rightly rejected.
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Helpline e-mail ID for technical query related to online fee and form submission is recruitment.help@nitp.ac.in
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Application along with the relevant enclosures should reach the Registrar, National Institute of Technology Patna, Ashok Rajpath, Patna – 800005, on or before 10th October 2022, 5:00 PM through speed post / registered post only, the envelope should be subscribed with the name of the post applied for. Application received after last day will be rejected. Institute shall not be held responsible for postal delay due to any reason.
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The Institute reserves the right to extend the closing date for receipt of applications and also reserves the right to postpone / cancel the recruitment for any / all posts at any stage.
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(xl) Decision of the Institute regarding conduct of written / skill test(s), verification of documents and selection would be final and binding on all applicants. No representation / correspondence will be entertained in this regard.
(xli) The Institute may decide to conduct a selection process comprising of multiple stages for selection of candidates. Details of selection process will be published well in advance on the Institute website www.nitp.ac.in .
(xlii) Any dispute arising out of this advertisement can be instituted in any court within Patna jurisdiction.
Registrar
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Technical Assistant Annexure-II
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Sl. No. |
Requirement |
Category with No. of position |
Essential Qualification and Desirable Experience/Knowledge in Trade/Field/ Branch of Study |
|
1. |
Technical Assistant in Water Resources and Hydraulic Engineering |
UR: 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Civil Engineering from a recognized University/ Institute. OR First Class Diploma in Civil Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in Water Resources and Hydraulic Engineering lab. |
|
2. |
Technical Assistant in Heavy structure |
ST: 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Civil Engineering from a recognized University/ Institute. OR First Class Diploma in Civil Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in Heavy structure |
|
3. |
Technical Assistant in Power System Lab |
UR: 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Electrical Engineering from a recognized University/ Institute. OR First Class Diploma in Electrical Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling Experiments in Power System lab. |
|
4. |
Technical Assistant in Electrical Machine Lab/ Basic Electrical Engineering Lab. |
OBC(NCL): 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Electrical Engineering from a recognized University/ Institute. OR First Class Diploma in Electrical Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling |
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experiments in Electrical Machine and Basic Electrical Engineering Lab. |
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5. |
Technical Assistant in RF and Microwave Engineering |
UR: 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Electronics & Communication Engineering from a recognized University/ Institute. OR First Class Diploma in Electronics & Communication Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in RF and Microwave Engineering. |
|
6. |
Technical Assistant in VLSI |
UR: 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Electronics & Communication Engineering from a recognized University/ Institute. OR First Class Diploma in Electronics & Communication Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments using FPGA boards. Familiarization with PCB design and basic VLSI tools. Basic knowledge of HDL Language. |
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7. |
Technical Assistant in communication Engineering and signal Processing |
PwD: 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Electronics & Communication Engineering from a recognized University/ Institute. OR First Class Diploma in Electronics & Communication Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in communication Engineering and signal processing. Familiarization with Basic DSP boards. |
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8. |
Technical Assistant in Microprocessor/ Microcontroller |
OBC(NCL): 01 |
Essential: First class or equivalent Grade in BE/B.Tech in Electronics & Communication Engineering from a recognized University/ Institute. OR |
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First Class Diploma in Electronics & Communication Engineering with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in Microprocessor / Microcontroller and Skills of Embedded system design. |
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9. |
Technical Assistant in Physics lab |
UR: 01 |
Essential: First Class or Equivalent Grade in B.Sc Physics from a recognized University/ Institute. OR Master’s Degree in Physics from a recognized University/ Institute with at least 50% marks or equivalent grade. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in Physics Lab |
|
10. |
Technical Assistant for Chemistry lab |
SC: 01 |
Essential: First Class or Equivalent Grade in B.Sc Chemistry from a recognized University/ Institute. OR Master’s Degree in Chemistry from a recognized University/ Institute with at least 50% marks or equivalent grade. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in Chemistry Lab. |
|
11. |
Technical Assistant for Architecture Lab/Studio |
UR: 01 OBC(NCL): 01 |
Essential: First Class or equivalent Grade in B.Arch. from a recognized University/ Institute. OR First Class Diploma in Architecture with excellent academic record. Desirable Experience/Knowledge: Having sufficient knowledge in handling experiments in Architecture Lab/Studio. |
|
12. |
Technical Assistant for Server Administration |
UR: 01 OBC(NCL): 01 |
First class or equivalent Grade in BE/B.Tech in Computer Science Engineering/relevant engineering or MCA from a recognized University/ Institute. OR First Class Diploma in Computer Science Engineering with excellent academic record. |
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Desirable Experience/Knowledge: Working experience of at least Three Years in reputed organisation in following domain:
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13. |
Technical Assistant for Programming |
UR: 01 SC: 01 |
First class or equivalent Grade in BE/B.Tech in Computer Science Engineering/relevant engineering or MCA from a recognized University/ Institute. OR First Class Diploma in Computer Science Engineering with excellent academic record. Desirable Experience/Knowledge: Working experience of at least Three Years in reputed organisation in following domain:
Knowledge of VC support and management |
|
14. |
Technical Assistant for Network Administration |
SC: 01 |
First class or equivalent Grade in BE/B.Tech in Computer Science Engineering/relevant engineering or MCA from a recognized University/ Institute. OR First Class Diploma in Computer Science Engineering with excellent academic record. Desirable Experience/Knowledge: |
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Working experience of at least Three Years in reputed organization in following domain:
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15. |
Technical Assistant for Hardware |
EWS: 01 |
First class or equivalent Grade in BE/B.Tech in Computer Science |
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Engineering/relevant engineering or MCA |
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from a recognized University/ Institute. |
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OR |
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First Class Diploma in Computer Science |
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Engineering with excellent academic record. |
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Desirable Experience/Knowledge: |
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Working experience of at least Three Years in reputed organization in following domain:- |
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16. |
Technical Assistant for Web Programming |
OBC(NCL): 01 |
First class or equivalent Grade in BE/B.Tech in Computer Science Engineering/relevant engineering or MCA from a recognized University/ Institute. OR First Class Diploma in Computer Science Engineering with excellent academic record. Desirable Experience/Knowledge: Working experience of at least Three Years in reputed organization in following domain:-
Proper Lab Management |
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A candidate who claims to belong to one of the Scheduled Caste or the Scheduled Tribes should submit in support of his claim an attested/certified copy of a certificate in the form given below, from the District Officer or the sub-Divisional Officer or any other officer as indicated below of the District in which his parents(or surviving parent) ordinarily reside who has been designated by the State Government concerned as competent to issue such a certificate. If both his parents are dead, the officer signing the certificate should be of the district in which the candidate himself ordinarily resides otherwise than for the purpose of his own education. Wherever photograph is an integral part of the certificate, the Commission would accept only attested photocopies of such certificates and not any other attested or true copy.
(The format of the certificate to be produced by Scheduled Castes and Scheduled Tribes candidates applying for appointment to posts under Government of India)
This is to certify that Shri/Shrimati/Kumari* son/daughter of
of village/town/* in District/Division
* of the State/Union Territory*
belongs to the Caste/Tribes Castes/Scheduled Tribes* under:-
which is recognized as a Scheduled
The Constitution (Scheduled Castes) order, 1950 The Constitution (Scheduled Tribes) order, 1950
The Constitution (Scheduled Castes) Union Territories order, 1951 *
The Constitution (Scheduled Tribes) Union Territories Order, 1951*
As amended by the Scheduled Castes and Scheduled Tribes Lists(Modification) order, 1956, the Bombay Reorganization Act, 1960 & the Punjab Reorganization Act, 1966, the State of Himachal Pradesh Act 1970, the North-Eastern Area(Reorganization) Act, 1971 and the Scheduled Castes and Scheduled Tribes Order(Amendment) Act, 1976.
The Constitution (Jammu & Kashmir) Scheduled Castes Order, 1956
The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by the Scheduled Castes and Scheduled Tribes order (Amendment Act), 1976*.
The Constitution (Dadra and Nagar Haveli) Scheduled Castes order 1962. The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order 1962@. The Constitution (Pondicherry) Scheduled Castes Order 1964@
The Constitution (Scheduled Tribes) (Uttar Pradesh) Order, 1967 @ The Constitution (Goa, Daman & Diu) Scheduled Castes Order, 1968@ The Constitution (Goa, Daman & Diu) Scheduled Tribes Order 1968 @ The Constitution (Nagaland) Scheduled Tribes Order, 1970 @
The Constitution (Sikkim) Scheduled Castes Order 1978@
The Constitution (Sikkim) Scheduled Tribes Order 1978@
The Constitution (Jammu & Kashmir) Scheduled Tribes Order 1989@ The Constitution (SC) orders (Amendment) Act, 1990@
The Constitution (ST) orders (Amendment) Ordinance 1991@ The Constitution (ST) orders (Second Amendment) Act, 1991@ The Constitution (ST) orders (Amendment) Ordinance 1996
The Scheduled Caste and Scheduled Tribe Orders(Amendment ) Act 2002. The Constitution (Scheduled Caste) Orders(Amendment) Act 2002.
The Constitution(Scheduled Caste and Scheduled Tribe) Orders(Amendment) Act 2002. The Constitution (Scheduled Caste) Order (Amendment) Act 2007.
%2. Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated from one State/Union Territory Administration.
This certificate is issued on the basis of the Scheduled Castes/ Scheduled tribes
certificate issued to Shri/Shrimati
of
Father/mother
Shri/Srimati/Kumari* of village/town*
in District/Division* Territory*
of the State/Union
who belong to the Caste/Tribe which is recognized as a Scheduled Caste/Scheduled Tribe in the State/Union Territory* issued by the
dated .
%3. Shri/Shrimati/Kumari and /or * his/her family ordinarily reside(s) in
village/town* of
District/Division* of the State/Union Territory of
Place Date
Signature
** Designation (with seal of office)
* Please delete the words which are not applicable @ Please quote specific presidential order
% Delete the paragraph which is not applicable.
NOTE: The term ordinarily reside(s) used here will have the same meaning as in section 20 of the Representation of the People Act, 1950.
** List of authorities empowered to issue Caste/Tribe Certificates:
-
District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/Additional Deputy Commissioner/Dy.Collector/Ist Class Stipendiary Magistrate/Sub-Divisional Magistrate/Extra-Assistant Commissioner/Taluka Magistrate/Executive Magistrate.
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Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.
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Revenue Officers not below the rank of Tehsildar.
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Sub-Divisional Officers of the area where the candidate and/or his family normally resides.
NOTE: ST candidates belonging to Tamil Nadu state should submit caste certificate ONLY FROM THE REVENUE DIVISIONAL OFFICER.
Form-V Certificate of Disability
(In cases of amputation or complete permanent paralysis of limbs or dwarfism and in case of blindness)
[See rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)
Recent passport size attested photograph
(Showing face only) of the person with disability.
Certificate No. Date:
This is to certify that I have carefully examined Shri/Smt./Kum.
son/wife/daughter of Shri
Date of Birth (DD/MM/YY)
Age
years, male/female
registration No. permanent resident of House
No.
Ward/Village/Street
Post Office
District State is affixed above, and am satisfied that:
-
he/she is a case of:
-
locomotor disability
-
dwarfism
-
blindness
(Please tick as applicable)
, whose photograph
-
-
the diagnosis in his/her case is
-
-
he/she has % (in figure) percent (in words) permanent locomotor disability/dwarfism/blindness in relation to his/her
(part of body) as per guidelines ( ……………number and date of issue of the guidelines to be specified).
2. The applicant has submitted the following document as proof of residence:-
1
|
Nature Document |
of |
Date of Issue |
Details of authority issuing certificate |
(Signature and Seal of Authorised Signatory of
notified Medical Authority)
Signature/thumb impression of the person in whose favour certificate of disability is issued
2
Form – VI Certificate of Disability
(In cases of multiple disabilities) [See rule 18(1)]
(Name and Address of the Medical Authority issuing the Certificate)
Recent
size
passport
attested
photograph
(Showing face only) of the person
with disability.
Certificate No. Date:
This is to certify that we have carefully examined Shri/Smt./Kum.
son/wife/daughter of Shri
Date of Birth (DD/MM/YY)
Age years, male/female .
Registration No. permanent resident of House No.
Ward/Village/Street Post Office District
State , whose photograph is affixed above, and am satisfied that:
-
he/she is a case of Multiple Disability. His/her extent of permanent physical impairment/disability has been evaluated as per guidelines (……………number and date of issue of the guidelines to be specified) for the disabilities ticked below, and is shown against the relevant disability in the table below:
S. No
Disability
Affected part body
of
Diagnosis
Permanent physical impairment/mental
disability (in %)
1.
Locomotor
disability
@
2.
Muscular
Dystrophy
3.
Leprosy cured
4.
Dwarfism
5.
Cerebral Palsy
1
6.
Acid attack Victim
7.
Low vision
#
8.
Blindness
#
9.
Deaf
£
10.
Hard of Hearing
£
11.
Speech and
Language disability
12.
Intellectual
Disability
13.
Specific Learning
Disability
14.
Autism Spectrum
Disorder
15.
Mental illness
16.
Chronic Neurological
Conditions
17.
Multiple sclerosis
18.
Parkinson’s
disease
19.
Haemophilia
20.
Thalassemia
21.
Sickle Cell disease
-
In the light of the above, his/her over all permanent physical impairment as per guidelines (……….number and date of issue of the guidelines to be specified), is as follows : –
In figures percent
In words :- percent
-
This condition is progressive/non-progressive/likely to improve/not likely to improve.
-
Reassessment of disability is :
-
not necessary, or
-
is recommended/after …………… years ……………. months, and therefore this certificate shall be valid till —– —– ——
(DD) (MM) (YY)
@ e.g. Left/right/both arms/legs # e.g. Single eye
2
£ e.g. Left/Right/both ears
-
-
The applicant has submitted the following document as proof of residence:-
Nature of document
Date of issue
Details of authority issuing certificate
-
Signature and seal of the Medical Authority.
|
Name and Member |
Seal |
of |
Name and Member |
Seal |
of |
Name and Seal of the Chairperson |
Signature/thumb impression of the person in whose favour certificate of disability is issued.
3
FORM-VII
(As per RPD Act, 2016)
Certificate of Disability
(In cases other than those mentioned in Forms-V & VI)
{See Rule 18(1)}
(Name and Address of the Medical Authority issuing the Certificate)
Recent Passport size Attested Photograph (Showing face only)
Of the Person with Disability
Certificate No.: Date :
This is to certify that I have carefully examined Shri/Smt/Ms.
, son/wife/daughter of Shri
, Date of Birth (DD/MM/YY) Age
years, male/female , Registration No.
, permanent resident of House No. , Ward/Village/Street
Post Office District
State , whose
photograph is affixed above and am satisfied that he/she is a case of
Disability. His/Her extent of permanent physical impairment / disability has been evaluated as per guidelines ( number and date of issue of the guidelines to be specified) and is shown against the relevant disability in the table below:
|
Sr. No. |
Disability |
Affected Part of Body |
Diagnosis |
Permanent Physical Impairment / Mental Disability (in %) |
|
1 |
Locomotor disability |
@ |
||
|
2 |
Muscular Dystrophy |
|||
|
3 |
Leprosy cured |
|||
|
4 |
Dwarfism |
|||
|
5 |
Cerebral Palsy |
|||
|
6 |
Acid Attack Victim |
|||
|
7 |
Low Vision |
# |
||
|
8 |
Blindness |
# |
||
|
9 |
Deaf |
* |
||
|
10 |
Hard of Hearing |
* |
||
|
11 |
Speech & Language disability |
|||
|
12 |
Intellectual disability |
|||
|
13 |
Specific learning disability |
|||
|
14 |
Autism Spectrum Disorder |
|||
|
15 |
Mental Illness |
|||
|
16 |
Chronic Neurological Conditions |
|||
|
17 |
Multiple Sclerosis |
|||
|
18 |
Parkinson’s disease |
|||
|
19 |
Haemophilia |
|
Sr. No. |
Disability |
Affected Part of Body |
Diagnosis |
Permanent Physical Impairment / Mental Disability (in %) |
|
20 |
Thalassemia |
|||
|
21 |
Sickle Cell disease |
(Please strike out the disabilities which are not applicable)
@ e.g. Left / Right / Both Arms / Legs # e.g. Single Eye
* e.g. Left / Right / Both Ears
-
The above condition is progressive / non-progressive / likely to improve / not likely to improve.
-
Reassessment of disability is:
-
not necessary, or
-
is recommended / after years months, and therefore, this certificate shall be valid till (DD) (MM) (YY).
-
-
The applicant has submitted the following document as proof of residence:
|
Name of Document |
Date of Issue |
Details of Authority issuing Certificate |
(Authorised Signatory of Notified Medical Authority
(Name & Seal)
Countersigned
{Countersignature & Seal of the Chief Medical Officer / Medical Superintendent / Head of Government Hospital, in case the Certificate is issued by a Medical Authority who is not a Government Servant (with Seal)}
Signature / thumb impression of the person in whose favour certificate of disability is issued
Note : In case this certificate is issued by a Medical Authority, who is not a Government Servant, it shall be valid only if Countersigned by the Chief Medical Officer of the District.
