PROFORMA FOR THE REGULARISATION OF TEMPORARY SERVICE

1. Name of the individual

2. Date of Birth

3. Station to which attached

4. SL. No. Order No. Date in which
Appointed temporarily

5. Date of joining on the first
Appointment specify F/N (or) A/N

6. Whether the individual has satisfy The
age rule at the time order no and date
of relaxation of age rule obtained

7. Whether the individual has produced
all The certificate at the time of joining
on first Appointment including
PHYSICAL FITNESS CERTIFICATE

8. General Education Qualification

9. Technical Qualification

10. Whether He (or) She Has Studied
Tamil As Second Language Test

11. Whether He (or) She Passed Language
Test

12. Name of the Intuition undergone
Indian medical University of the
Completion of the course MBBS

13. Name of the intuition under gone
Indian medical University of the
Completion of the course MBBS
(Which Period)

14. Registration No & Date of Medical
Council of Tamilnadu

15. Registration No And Date of TNPSC
(Tamilnadu Medical Service
Commission) Passed and seniority No.

16. Whether the individual has availed any
kind of leave if so the nature of leave
sanction of which period of leave

17. Whether any pending disciplinary
action is pending /Contemplated
against the individual

18. Name of the previous station last
worked

19. Special Test Pass year and registration
No :

20. Date of completion of regular service
from one year

21. Date of completion of probation
service from two year


Certified that the particulars furnished he /she in the proforma have been verified with
reference to service register of the individual and found correct











PROFORMA
1. SI.No
2. T.N.P.S.C. Seniority No.
3. Name and Designation
4. Date of Birth
5. Appointment order no and Date
6. Examination Passed
a) TNPSC /Year
b) Special qualifying exam /year

7. Date of joining service FN/AN should be mentioned
without fail
a) 10 (a) (1)
b) Regular TNPSC /Reserve list
c) Special qualification exam

8. Present working station
9. Certificate to the effect that original physical fitness
Certificate if found to be in order and pasted in the
service register of the individual

10. Remarks


Signature of the
Ddhs/ Dean