POST APPLIED FOR Medical officer________________________ Affix recent passport size

photograph
Name of Polyclinics applied for Khanabal___________________

1. Name Dr. GAWHAR ABBAS KHAN ______________________

(If Ex-serviceman No __NA_________Rank____NA_________

Arms/service______NA_________until last served______NA______

2 Date of birth ________04 May 1962____________________________

3 Sex: M/F ______Male______________________________________

4 Postal Address VPO. Gopalpora Kalan_TEH. MATTAN DIST. ANANTNAG

Pin 192125 Mob No 7006945587 E-Mail ID gowharabbas786@gmail.com

5. Educational Qualification (Photocopies duly attested to be attached)

Qualification Year of Place of No of % marks

Passing Passing Attempts

(a) 10th (matric) 1977 jkbose one

th
(b) 12 1979 -do- one
(c) MBBS 1989 KASHMIR one
UNIVERSITY
(d)
(f)

6 Work experience (Experience certificate must be attached for consideration)

Place of work/Hospital Period of Employment Reason for leaving job

GMC Srinagar 22-1-1990 to 21-1- -
(internship) 1991
GMC Srinagar( Chest 22-1-1991 to 22-1- -
diseases hospital 1992
Srinagar)
PHC Shangus (Adhoc Mar 1992 to Dec 1994 -
Medical Officer)
PHC Dalgam (Adhoc Jan 1995 to 30 Sept -
Medical Officer) 1997
Medical Block Mattan 01-10-1997 to 31-03- -
(Medical Officer) 2000
D T C Anantnag 01-04-2000 to 31-04- -
(Medical Officer) 2002
Medical block mattan 01-05-2002 to 31-03- -
(Medical Officer) 2004
Medical block mattan 01-04-2004 to 31-07- -
(Medical Officer) 2006
Medical Block Mattan 01-08-2006 to 30-09- -
(BMO) 2015
Medical Block Achabal 01-10-2015 to 31-07- -
 (BMO) 2017
Medical Block Qaimoh 01-08-2017 to 31-03- -
(BMO) 2020
Medical Block Achabal 01-04-2020 to 31-05- Retired
(BMO) 2022

7 Registration No and date of registration with Indian/State Medical Council

4292 at 6-5-91__ (Photocopy of registration to be attached).

8 Honours and Awards (Professional & Service)__Certificate of Appreciation for Meritorious Service
from DC Anantnag,CMO Anantnag and Chairman BDC Achabal

9 Details of previous service in Army/Central/State Govt (Photocopy of ESM PPO__NA__

& Discharge book to be attached duly attested

10 Total pd of serving (including SSC if any) NA__________________

11 Details of Previous service if any with ECHS and reason for termination

NA____________________________________________

Declaration

1. hereby solemnly declare that all the statement made in the above application

are true and correct to be best of my knowledge and belief.

2. I fully understand and that in the events of any information furnished being found

false or incorrect, action can be taken against me.

Place_______Anantnag_____ Signature___________________________

Date_____May 2023______ Name of applicant (Dr. Gawhar Abbas Khan)