power system operation corporation limited · call letter for document verification and format for...
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POWER SYSTEM OPERATION CORPORATION LIMITED (A Government of India Enterprise) Regd. Office: B-9 (1
st Floor), Qutab Institutional Area, Katwaria Sarai, New Delhi -110016
Crop.Centre: IFCI Tower, 9th
Floor ,Nehru Place, New Delhi
Date: 04th June, 2018
NOTICE
LIST OF CANDIDATES SHORTLISTED AGAINST VACANCIES NOTIFIED FOR POSOCO BY POWERGRID FOR RECRUITMENT FOR THE POST OF JUNIOR OFFICER TRAINEE (HR)
Based on performance of candidates in the written test (Computer Based Test) conducted by POWERGRID on behalf of POSOCO, for the post of “Junior officer Trainee (HR)”, the following candidates are provisionally shortlisted for verification of documents against vacancies notified for POSOCO only, subject to their fulfilling the eligibility criteria as notified in detailed Advertisements issued by POWERGRID.
The short-listed candidates are advised to report for document verification as per details below.
Time : 09:00 AM
Date : 08th
June, 2018
Venue : POWER SYSTEM OPERATION CORPORATION LIMITED, IFCI Tower, 9th Floor, Nehru Place, New Delhi – 110016
After documentation, the said candidates are required to undergo Pre-Employement Medical Test. Details of which are as follows :-
Time : 11:00 AM
Date : 08th
June, 2018
Venue : Sitaram Bhartia Institute of Science & Research, B-16, Qutab Institutional Area, Block B Road, New Delhi- 110016.
LIST OF CANDIDATES SHORT-LISTED FOR THE POST OF JUNIOR OFFICER TRAINEE (HR)
S.N ROLLNO REG.NO NAME OF THE
CANDIDATE FATHER’S/GUARDIAN’S
NAME
1 152310109 824396 Uttam Kumar Singh Ashok Singh
2 152340189 831665 Jayant Oscar Minz Sunil Minz
3 152310094 836552 Shivangi Rai Tapo Vardhan Rai
4 152310063 831369 Pankaj Kumar Singh Bachchan Singh
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On successful completion of the document verification process they shall be issued Offer of Appointment followed by Pre-Employment Medical Examination on the dates mentioned against their names. On being found medically fit, they shall be required to join immediately and complete the joining formalities.
Call Letter for Document verification and other necessary document short-listed candidates will be mailed to the candidate. They are advised to go through the contents of letter and its enclosed documents carefully. Further, they are advised to bring the following documents as listed below:
LIST OF DOCUMENTS REQUIRED TO BE BROUGHT FOR VERIFICATION
Document in original along with one set photocopy: 1. Resume (enclosed) 2. Call letter for Document verification and format for Pre-Employment medical examination report (enclosed) 3. Four latest Passport size colour photograph. 4. Following documents in original along with one set photocopy (duly self-attested):
i. Date of Birth Certificate – Matric/Birth Certificate ii. Educational Qualifications Certificate along with mark sheets all years / semesters following examination.
a) Matriculation b) Intermediate (if applicable) c) Diploma/Degree (as applicable) d) Any other Qualification
iii. Proof of norms adopted by the University/Institute to convert CGPA/OGPA/DGPA into percentage (wherever applicable).
iv. Experience/ service Certificate in the letter head of Company clearly indicating the post held, period of service, gross emoluments, area of experience as proof of post qualification Experience duly certified by Organization concerned(if applicable).
v. “No Objection Certification” from your present employer, in case you are already employed in State/Central/Public Sector/Autonomous undertaking (if applicable).
vi. SC/ST Certificate, in the prescribed GOI format Competent Authority, if applicable. vii. Latest OBC (NCL) Certificate (issued in the Financial year 2017-18), in the prescribed GOI format from
Competent Authority, if applicable. viii. Declaration Form regarding Non Creamy Layer status in respect of OBC (NCL) candidates in the prescribed
format. ix. Disability Certificate in case of PwD candidate in the prescribed format, if applicable. x. ID proof viz. Driving License/Passport/Aadhar Card/PAN Card etc. xi. Discharge Certificate, Undertaking and Performa of Certificate for Employed Official in case of Ex-
Servicemen in the prescribed format, if applicable xii. Certificate in the prescribed format issued by Competent Authority in respect of J&K Domicile/Victims of
Riots, if applicable.
5. Service Agreement Bond duly signed by candidate and the person standing surety for candidate as per mentioned in the enclosed terms and candidates of appointment. Guideline for executing Service Agreement Bond is enclosed along with the offer. Candidates are advised to study the guidelines carefully before executing the Bond. Candidates may note that they shall not be allowed to join without the Service Agreement Bond completed in all respects.
6. Character Certificates from two different persons not related to candidate from amongst the following: (a) Gazetted Officer of Central or State Government; (b) Member of Parliament/State Legislature or Municipal Bodies; (c) District Magistrate of Sub-Division Magistrate;
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(d) Tehsildar or Deputy Tehsildar; (e) Principals of the recognized Educational Institutions last attended.
7. Attestation Forms (4 in numbers) duly filled and signed by any of the persons as mentioned in the enclosed Form.
8. Duly filled in Pre-Employment Medical Examination Report (Part-I)
In case the candidate fails to bring any of the above mentioned certificates/documents or if they are found not meeting the eligibility criteria specified in the detailed advertisement, then his/her candidature will be rejected and he/she will not be allowed to appear for the Pre-employment Medical Exam and shall not be considered any further. Mere appearance in the Document verification and /or pre-employment Medical examination, does not entitle candidates for employment in POSOCO. Eligibility is further subject to check/verification at various stages during/after the selection process. Candidates may be required to stay for 1-2 days at their own expense for completion of Document verification, Pre-Employment Medical Examination & joining formalities. On successful completion of all the formalities, they shall be required to report at the training location immediately. Accordingly, they are advised to come prepared with their bag and baggage. It may be noted that TA shall be paid only to those candidates who are found medically fit and report for joining at the place of training. We take this opportunity to welcome you to the POSOCO family & look forward to long and fruitful association and wish you an exciting career ahead.
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STANDARDS FOR MEDICAL FITNESS
Sl. Organ/Sys. Details/ Test/ Examination Standards Criteria for Disqualification
1. GENERAL
EXAMINA
TION
Height,
Weight,
BMI
Measurement Minimum height requirement for drivers is
162 cms.
Age up to 35 yrs- BMI max-30 kg/m2
Age above 35 yrs- BMI max-32 kg/m2
Medical Authority should use his clinical
discretion for abnormal height, weight & BMI
for further clinical evaluation for medical
fitness.
Significant underweight/ overweight & height
more than 200 cms needs further investigations
before declaring FIT.
BMI above the maximum limit will be a
disqualification.
Chest Measurement Minimum in full expiration 79 cm
(relaxable by 5 cm) and minimum
expansion 5 cm. The range of expansion
upto 4 cm i.e. deviation of 20% will be
acceptable. Not applicable to female
candidate
Glands &
others
Physical examination Thyroid should be normal with no
evidence of hypo or hyper thyroidism or
Generalized enlargement of lymph glands.
Scars, if any of the previous removal of
tubercular glands should be normal and
there must not have been any active
disease in last five years
Any lymphadenopathy to be thoroughly
investigated to rule out chronic granulomatous
disease like tuberculosis, sarcoidosis and blood
dyscrasias.
Individuals with diabetes will be temporarily
unfit for max. 21 days if their blood sugar level
is not in normal limit. HbA1C should be at or
less than 7.0. If after 21 days, it is still in
abnormal range or HbA1C is above 7.0 then
they will be Unfit.
Diabetics with any target organ involvement
e.g. nephropathy, retinopathy, neuropathy etc.
will be declared Unfit.
Blood Sugar Within normal limits
2 EAR Hearing standards will be tested in a quiet
room. Doctor and candidate will stand at a
distance of 20 ft. from each other. Both the
ear will be examined separately. The ear not
being tested will be marked by a masking
apparatus or by rubbing a piece of paper
against pinne by an attendant. The candidate
will face at right angles the doctor with the ear
under examination facing him. He will use the
whispering voice.
Candidate should be free from any active
disease of ear and should be able to
reproduce the whisper.
Candidate who fails to hear whispering voice
separately in both ears at a distance of 2 feet in
a quiet room.
3 NOSE General examination Should be free from active disease of nose.
Sl. Organ/Sys. Details/ Test/ Examination Standards Criteria for Disqualification
4 THROAT State of tonsils Throat, palate, gums, jaws, temporo-
mandibular joint and dentitions within
normal limits
Slight hypertrophy without evidence of repeated tonsillitis
is not a cause of rejection.
Enlarged tonsils cause temporary unfitness until treated
with tonsillectomy.
5 EYES General Examination Any morbid condition of eyes, eye-lids or contiguous structures
of such a nature as would render him/ her unfit for service at the
time of appointment or at a future date.
Trachoma, unless complicated, shall not ordinarily be a cause for
disqualification. Visual Acuity for
Both Eyes (with or
without glasses /
contact lenses/IOL/
Implantable
Contact lenses)
Distant Vision test
& Near Vision
test
Age in
Yrs.
Distant Vision Near Vision Any organic disease or a progressive refractive error which is
likely to result in lowering of the visual acuity.
For technical skilled jobs where binocular vision is essential,
squint is considered as disqualification.
For other services squint is not a disqualification if visual acuity
is of prescribed standard.
Better
Eye
Worse
Eye
Better
Eye
Worse
Eye
Below
35
6/9
6/6
6/9
6/12
Sn 0.6 Sn 0.6
35 &
ab.
6/12
6/9
6/12
6/18
Sn 0.8 Sn 0.8
Fundus Fundus
examination
Fundus and media should be healthy and
within normal limits.
Any progressive pathological condition, Vitreous or
Choriorentinitis, Any retinal disease in Diabetes,
Hypertension, Atherosclerosis,
Corrected Myopia (including the cylinder) exceeding -6D
and Hypermetropia +4D in each eye up to 35 years of age,
Corrected Myopia (including cylinder) exceeding -6D and
Hypermetropia +6D in each eye beyond 35 years of age
Colour Vision Ishiara’s
Isochromatic
plates in good
light
Normal Colour Vision.
Candidates should identify individual
colours separately and pass pink
perception test.
Colour blindness is a disqualification for all technical
positions/ jobs / other occupations where perception of
colour is essential in view of nature of duties of the offered
post or future posts likely to be occupied by the candidate
excepting employment in HR, Finance, accounts, clerical,
ministerial, canteen peons, attendants and any other
category where defective colour vision is not likely to
interfere with his work create risk for others.
Night Vision Dark room test Normal night vision
One eyed person Prognosis or the functioning of eye is good
and it’s not likely to be endangered by the
condition of the worse eye and the prescribed
visual acuity standards are fulfilled.
For regular service one eyed person is unfit except for
ministerial and allied jobs where binocular vision is not
considered essential
Sl. Organ/Sys. Details/ Test/ Examination Standards Criteria for Disqualification
Eyes Field of Vision Field of vision
by confrontation
method/ Visual
field screener/
perimeter.
Should have good binocular vision,
fusion faculty and full field of
vision in both the eyes.
Defects in visual field to be thoroughly evaluated by specialists
before deciding on fitness.
6 RESPIRA-
TORY
SYSTEM
Physical examination , Chest X-
ray PA view
All parameters within normal limit. Pulmonary tuberculosis, Chronic obstructive pulmonary disease
will be a disqualification.
7 CARDIO
VASCUL
AR
SYSTEM
General
examination
Resting ECG
Normal ECG
Other parameters of heart size,
position, , rate, sounds , pulse
within normal limits
Organic/ Valvular/ Congenital heart disease non corrected with
definite clinical signs & symptoms will be a disqualification.
Any cardiac abnormality is to be further evaluated by relevant
tests and opinion of cardiologist to be taken for medical fitness.
Blood
pressure
Acceptable limit is 140/90 mm/Hg
without any target organ damage.
Candidates diagnosed as hypertensive will be further
investigated.
8 GENETO
URINARY
SYSTEM
Urine Routine/
microscopic
Within normal limits If any albumin, sugar or any other abnormality is detected,
further tests shall be conducted before deciding on fitness.
Non-orthostalic albuminuria cases will be Unfit.
Signs of incontinence of urine or enuresis, at the time of
pre-employment examination will declare candidate unfit
for employment.
Scrotum/
Testicles
Physical
examination
Normal Candidates with undescended testicles on one or both sides shall
be temporarily unfit for max. 21 days. Fitness can only be
granted if the candidate reports back with orchidectomy with
negative biopsy report for malignancy.
Candidate with hydrocele, piles, varicocele and hernia shall be
declared temporarily unfit for a max. period of 21 days.
Venereal Disease No evidence of VD Candidates who have suffered or are suffering from venereal
disease will not be declared fit unless detailed examination or
urethral smear and serological test prove negative.
Kidney Function Normal limits.
Presence of kidney/ uteric stone can
be considered after being surgically
corrected.
Any disease of genito urinary system to be further investigated
with Ultra-sound/ IVP and renal function test.
Cases of Polycystic kidney to be rejected.
Chronic renal disease to be a disqualification.
Sl. Organ/Sys. Details/ Test/ Examination Standards Criteria for Disqualification
9 SKIN Physical examination Treated/ cured Hansen’s disease
with no deformity is acceptable.
Vitiligo cases are acceptable
Candidates suffering from active leprosy or chronic and
inveterate skin conditions will be declared unfit.
10 NERVOUS
SYSTEM
Speech/ Gait
Nystagmus
Motor System
Sensory system
Reflex
Mental condition
There should be no evidence of
paralysis, palsy, epilepsy or any
signs of mental retardation or
neurological disorder.
Any Abnormality to be evaluated thoroughly before
appointment.
Candidates suffering from Epilepsy will be unfit, however,
Epileptic candidates under regular treatment may be accepted
for non-technical jobs only (excluding driver & security).
Candidates suffering from Paralysis / Stroke/ schizophrenia/
parkinsonism or any other major neurological disorder to be
unfit.
11 REPRODU
CTIVE
SYSTEM
(For
females
only)
Clinical examination Normal physical state of
development
Fibroid uterus, ovarian cyst should be removed before
appointment, if symptomatic & clinically significant.
Cases of pregnancy of 24 weeks or more at the time of medical
examination will be temporarily unfit until completion of six
weeks after miscarriage or 3 months after confinement. At the
end of the period fresh examination reqd.
Any lump in breast to be operated before making fit &
malignancy to be excluded.
12 MUSCULO
-
SKELETA
L SYSTEM
Clinical examination - Progressive musculoskeletal disorder will be disqualification.
Non-progressive congenital abnormality should be evaluated by
medical board.
If candidate is found unfit merely on grounds of high myopia, the matter should be examined by ophthalmologist to assess whether it is
pathological or not. If it is not pathological, then he/she may be declared fit subject to other visual requirements
Any Malignancy : any carcinoma, multiple myeloma and blood dyscrasias will be disqualification
Cancer with life expectancy highly reduced will be a disqualification
Cirrhosis of liver is a disqualification.
In case any critical disease is noticed then fitness will be decided by a 3 Member Govt. Medical Board / Specialist Medical Board duly
constituted by Appointing authority or Regional Head.
In case of presence of any disease not mentioned in the standards, the same is to be evaluated keeping in mind the objective of medical examination
and the definition of medical fitness as defined under POWERGRID Guidelines for Pre-employment Medical Examination.
CONFIDENTIAL
POWER SYSTEM OPERATION CORPORATION LIMITED B-9, 1
st Floor, Qutab Institutional Area, Katwaria Sarai,
New Delhi, Delhi 110016
MEDICAL EXAMINATION REPORT (For use and retention in HR Department)
Passport size Photograph with signature of
candidate attested by POSOCO Official
PART – I
Post for which selected: ____________________Ref. No.________________ ________________
Name:_________________________________________________________________________ Father/Husband’sName:___________________________________________________________
(in block letters)
Date of Birth :_______________________________Place of Birth:_________________________
Age:___________Permanent Address __________________ _____________________________
_______________________________________________________________________________
Candidate’s statement and declaration (To be completed before medical examination)
Sl Question Yes No 1. Have you ever had/ Do you suffer from any of the following
Ear Disease
Any disease of Eyes
Night blindness
Colour blindness
Any disease of mouth cavity
Lung disease- Asthma/ spitting of blood
Tuberculosis
Mental Illness/ Neurological disorder/ Epilepsy/Headaches
Fainting attacks
High Blood Pressure
Stroke
Heart disease
Diabetes
Liver Disease
Kidney Disease
Leprosy
Cancer
Any deformities in extremities
Any abdominal disease
POSOCO/ Medical Examination Page 1 of 10
: : 2 : :
Sl Question Yes No
Any piles, fissure, hydrocele
2 If answer to any of the above is YES, Please give details
3 Any other disease of accident requiring confinement to bed and
medical or surgical treatment? If YES, Please give details
4 Are you on any prolonged medication
5 Have you been examined and declared unfit for Government service
by a medical officer/ medical board within the last three years? If
YES, Please give details
6 When you were last vaccinated? Date / Month & Year
Which vaccination?
7. Furnish the particulars concerning your family:
Father’s age if Father’s age at death and Mother’s age if living Mother’s age at death
living and state of cause of death and and cause of death
health state of health
No. of brothers No. of brothers dead, No. of sisters living, No. of sisters dead, living, their ages & their ages at death and their ages and state of their ages at death, and
state of health cause of death health cause of death
POSOCO/ Medical Examination Page 2 of 10
: : 3 : :
8. Marital Status : Single/ Married/ Widowed/ Widower/ Divorced
9. No. of Children : Male ___________________Female__________________
10. Family Planning History : Vasectomy/ Tubectomy / Not Applicable
11. Please specify any significant information if not covered above.
I declare all the above answers to be true and correct, to the best of my knowledge and belief. If at
any point of time it is found that I have suppressed or hidden any information or submitted any
wrong information, my candidature will be liable for rejection and if appointed my services will be liable for termination along with forfeiting all claims of Provident Fund, Gratuity and other
benefits.
Candidate’s Signature
Date: Signed in my presence:
Signature of Medical Officer
Date:
POSOCO/ Medical Examination Page 3 of 10
PART – II (To be recorded by the Authorized Medical Officer)
A. Identification marks : 1 2
B. Appearance
1. Age : ____________ Years
2. Physique : Well built / thin built
3. Temperament : Sober / Nervous / Irritable
4. Marks of primary vaccination : Present/ Absent
5. Deformities :
6. Operation scars :
C. General Physical Examination
1. Height without shoes : Cms.
2. Weight without shoes : Kgs.
3. Chest in full expiration : Cms.
4. Chest in full inspiration : Cms.
5. Abdomen over naval-stripped : Cms.
6. BMI :
7. Lymph Nodes :
8. Thyroid :
9. Additional Findings :
D. ENT & Dental Examination
1. Teeth : Clean/ dirty/ missing/ dentures
2. Gums : Healthy/ unhealthy
3. Tongue : Clean/ coated
4. Throat : Normal/ congested/ tonsils
5. Nose :
6. Hearing : RE: Normal/ Impaired LE: Normal/ Impaired
7. Tympanic membrane : RE LE
8. Ear discharge : Yes/ No Other abnormalities------------
E. Eyes/ Vision 1. Distant vision (Without glasses/lenses) : RE: LE:
2. Distant vision (with glasses/ lenses) : RE: LE:
3. Near vision(Without glasses/lenses) : RE: LE:
4. Near vision(with glasses/ lenses) : RE: LE:
5. Power of glasses / lens used : Dioptre (No.) Dioptre (No.)
6. Contact lenses :
7. Whether suffering from squint or any :
other morbid condition of eyes or eyelids
8. Field of vision (if required)
9. Colour vision :
10. Night Blindness : Page 4 of 10 POSOCO/ Medical Examination
11. Fundus examination :
12. Any other findings :
F. Respiratory System 1. Form of chest : Normal/ deformed
2. Lungs :
3. Respiration :
4. Breath sounds :
G. Cardio-Vascular System/ Heart 1. Pulse in upper and : Normal/ thickened/ varicose veins
lower extremities
2. Position of Heart :
3. Rate, Rhythm :
4. Sounds & any murmurs :
5. Blood vessels :
6. ECG Report :
7. Blood Pressure : Systolic mm Hg
Diastolic mm Hg
H. Alimentary System 1. Liver :
2. Spleen :
3. Abnormalities (piles, Fistula, peptic ulcer, etc.):
4. Any organomegaly :
I. Genito Urinary System 1. Urine
(a) Specific gravity :
(b) Albumin- : Present / Absent
(c) Sugar- : Present / Absent
(d) Microscopic pus cells :
2. Hernia- : Present / Absent
3. Evidence of V.D. :
4. Scrotum (For males) : Normal / Hydrocele / Bubonocele/ other
5. Testicles (For males) : Normal / Undescended
J. Reproductive System (for female candidates)
1. History of menstrual cycle : Regular / Irregular
2. Breasts :
3. Pregnancy with duration :
4. Local/ PV / P.S. Examination : (if required)
5. L.M.P. :
K. Nervous System
1. Mental condition :
2. Reflexes : POSOCO/ Medical Examination Page 5 of 10
3. Pupils
(a) Normal/ Abnormal
(b) Light reflexes- Present/ Absent :
4. Gait :
5. Specify any other evidence of disease : of nervous system except epilepsy
viz. paralysis, wasting, tremors, irregular
movements etc.
L. Mandatory Investigations
1. Blood examination
(a) CBC : (d) ESR :
(b) Blood Group : (e) FBS :
(c) Hb % : (f) PPBS :
2. Urine Routine / Microscopic
3. Stool
4. Ski gram chest (X-ray-PA view)
5. ECG
M. Other Investigations (If Required.)
1. Sputum Test 6. 2D-Echo Colour Doppler 2. S/ Creatinine 7. TMT/ Stress ECG 3. S/ Urea 8. Pulmonary Function Test 4. Ultrasound of abdomen 9. Liver Function Test 5. VDRL 10. Glycosylated Hemoglobin
11. Any other test ---------------------------------------------------------------------------------------------------------------------------------------------
Diseases found, if any Chronic / Non Chronic Treatable / Untreatable
(In case of any Critical Diseases, the case is mandatorily required to be referred to a Govt. Medical Board or Specialist Medical Board to be constituted by POSOCO)
Certified that Shri /Smt./ Km. __________________________________ a candidate selected for the post of
______________________________ whose signature/ thumb impression is appended below, is MEDICALLY
FIT/ UNFIT/ TEMPORARILY UNFIT (strike off whichever is not applicable).
OR
Certified that Shri /Smt./ Km. __________________________________ a candidate selected for the post of
______________________________ whose signature/ thumb impression is appended below, is suffering from a
critical disease as indicated above and is therefore referred for examination by Medical Board.
Remarks:
AUTHORISED MEDICAL OFFICER
Signature/ Thumb impression of the candidate
Signed before me
AUTHORISED MEDICAL OFFICER-------------------------------------------- Date:
POSOCO/ Medical Examination Page 6 of 10
PART-III
POWER SYSTEM OPERATION CORPORATION LIMITED
B-9, 1st Floor, Qutab Institutional Area, Katwaria Sarai,
New Delhi, Delhi 110016
Unit : (Medical Department)
Post for which selected :
Ref. No. :
MEDICAL CERTIFICATE OF FITNESS ON FIRST ENTRY INTO POSOCO’S SERVICE
(For retention by HR Department, POSOCO)
1. I hereby certify that I have examined Shri /Smt./ Km. ____________________________________
son/daughter/wife of ___________________________________________ a candidate for employment in POSOCO
and could not discover that he/she has any disease (communicable or otherwise) except
_________________________________.
I do/do not consider this as a disqualification for employment in the company. I, therefore, certify that
this candidate is medically FIT / UNFIT.
2. Shri/ Smt./ Km. _______________________________’s age according to his/her own statement is ______________
years and by his/her appearance, about ______________ years.
3. Identification marks (as recorded in the medical examination forms)
(a)
(b) ---------------------------------------------------------------------------------------------------------------------------------------
Signature of the candidate
MEDICAL OFFICER Date:
POSOCO/ Medical Examination Page 7 of 10
CONFIDENTIAL
PART-IV
POWER SYSTEM OPERATION CORPORATION LIMITED B-9, 1
st Floor, Qutab Institutional Area, Katwaria Sarai,
New Delhi, Delhi 110016
To,
Mr. / Ms -----------------------------------------------------
-------------------------------------------------------------------
-------------------------------------------------------------------
------------------------------------------------------------------
------------------------------------------------------------------
Subject: Medical Examination
Dear Sir/ Madam,
With reference to your medical examination held on _______________________, we have to inform you that you have
been found temporarily unfit on account of the following:
You may undergo the treatment to cure yourself of the above disease/sickness and appear for a re-
examination within________ weeks of the date of issue of this letter. You should produce a certificate of
treatment & cure from the Doctor who treated you alongwith corresponding test reports.
Yours faithfully,
MEDICAL OFFICER
STAMP OF HOSPITAL
CC: HR Department, POSOCO
POSOCO/ Medical Examination Page 8 of 10
PART-V
POWER SYSTEM OPERATION CORPORATION LIMITED
B-9, 1st Floor, Qutab Institutional Area, Katwaria Sarai,
New Delhi, Delhi 110016
Unit : (Medical Department)
Post for which selected :
Ref. No. :
MEDICAL CERTIFICATE OF FITNESS BY SPCIALISTS MEDICAL BAORD ON FIRST ENTRY INTO POSOCO’S
SERVICE (For retention by HR Department, POSOCO)
1. We hereby certify that we have examined Shri /Smt./ Km. ____________________________________
son/daughter/wife of ___________________________________________ a candidate for employment in
POSOCO. 2. He/ She is suffering from a critical disease __________________________________________________________. With
respect to the position for which he/ she is selected and nature of job in which he/ she is likely to be
engaged, we do / do not consider this as a disqualification for employment in POSOCO. We,
therefore, certify that this candidate is medically FIT / UNFIT.
3. Shri/ Smt./ Km. _______________________________’s age according to his/her own statement is ______________
years and by his/her appearance, about ______________ years.
4. Identification marks (as recorded in the medical examination forms)
(a)
(b) ---------------------------------------------------------------------------------------------------------------------------------------
Signature of the candidate Date:
(
)
(
)
(
)
SPECIALIST MEMBER SPECIALIST MEMBER
SPECIALIST MEMBER
STAMP
POSOCO/ Medical Examination Page 9 of 10
POWER SYSTEM OPERATION CORPORATION LIMITED
B-9, 1st Floor, Qutab Institutional Area, Katwaria Sarai,
New Delhi, Delhi 110016
Ref.: C/HR/Rectt./
Date :
Mr. / Ms ----------------------------------------------------- ------------------------------------------------------------------- ------------------------------------------------------------------- ------------------------------------------------------------------ ------------------------------------------------------------------ Sub. : Your Medical Examination
Dear Candidate,
With reference to your medical examination on ______________________________at ____________________________________we are sorry to inform you that you have been found medically Unfit on account of the following.
Hence your candidature for the post of ___________________________is hereby rejected.
The offer of appointment issued to you stands automatically withdrawn and cancelled with immediate effect. No further correspondences shall be entertained in this regard.
Thanking you,
Yours faithfully, For POSOCO
PO/ SR.PO/ DY. MGR(HR)/ MGR.(HR)
POSOCO/ Medical Examination Page 10 of 10
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 1 of 6
POWER SYSTEM OPERATION CORPORATION LIMITED Corporate Office : B-9, Qutab Institutional Area, Katwaria Sarai, New Delhi-110016
Tel.: 011-26524525. Fax : 011-26536901
1. Name in full (in block capitals) with
aliases. If any (Please indicate if you have added or dropped any part of your name or surname
SURNAME NAME
2. Present Address in full (i.e Village, Thana and District, or House Number Lane/ Street/Road and Town)
3. a. Home Address in full (i.e. Village.
Thana and District, or House Number, Lane/Street/ Road and Town and name of District Head- Quarters.
b. If Originally a resident of Pakistan, the address in that country and the date of (immigration to Indian Union.
WARNING : The furnishing of false information, suppression of any factual information inthe Attestation Form would be a disqualification, and is likely to render the candidate unfit foremployment under the Government.
If detained, convicted, debarred etc. subsequent to the completion and submission of thisform the details should be communicated Immediately to the Power Grid Corporation of India Ltd. or the authority to whom the attestation form has been sent earlier, as the case may be, failing which it will be deemed to be a suppression of factual information.
3. If the fact that false information has been furnished or there has been suppression of any factual information in the attestation form comes to notice at any time during the service of a person, his services would be liable to be terminated.
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 2 of 6
4. Particulars of places (with periods) of residences where you have resided for more than one year at a time during the preceding five years. In case of stay abroad (including Pakistan) particulars of all places where you have resided for more than one year after attaining the age of 21 years.
From To Residential address in full (i.e. village Thana
and Distt. or House No./lane/ Street/Road and Town)
Name of the District Headquarters of the place mentioned in the preceding column
5. . Name Nationality (by birth and/or by domestic)
Place of Birth Occupation (if employed, give designation and official address)
Present postal address (if dead, give last address)
Permanent Home Address
(i) Father’s Name (in full), Give aliases, if any
(ii) Mother
(iii) Wife/ Husband
(iv) Brother(s)
(v) Sister(s)
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 3 of 6
6. Information to be furnished with regard to son(s) and/or daughter(s) in case they are studying/living in a foreign country :-
Name Nationality (by birth and/or by domicile)
Place of Birth Country in which studying/ living with full address
Date from which studying/ living in the country mentioned in the previous column
7. Nationality ____________________________________________ 8.
(a) Date of Birth (a) ___________________________________________________________________________
(b) Present Age (b)
___________________________________________________________________________
(c) Age of Matriculation (c) ___________________________________________________________________________
9.
(a) Place of birth, District and state in which situated (a) ___________________________________________________________________________
(b) District and state to which you belong (b)
___________________________________________________________________________
(c) District and state to which your father originally belongs (c) ___________________________________________________________________________
10. (a) Your Religion (a)
___________________________________________________________________________
(d) Are you a member of Schedule Cast/Schedule Tribes/
Other backward class (Non creamy Layer)? Answer ‘Yes’ or ‘No’ and if the answer is ‘yes’ state the name of community thereof
(b) _________________________________________________________________________________
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 4 of 6
11. Educational Qualifications showing place of education with years in schools and colleges since 15th year of age.
Name of School/College with full
address
Date of Entering Date of Leaving Examination Passed
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 5 of 6
12. . a. Are you holding or have at any time held an appointment under the Central or State Government or a Semi-
Government or a Quasi Government body, or an autonomous body, or a Public Undertaking or a Private Firm or institution? If so. give full particulars with date of employment, upto date.
Period Designation, emoluments and nature of
employment
Full Name and Address
of Employer
Reasons of leaving
previous service From To
b. If the previous employment was under the Govt, of India, a State Govt/an undertaking owned or controlled by the Govt, of India or a State Govt./an autonomous body/University/Local body. If you had left service on giving a month's notice under Rule 5 of the Central Civil Services (Temporary' Service) Rules 1965. or any similar corresponding rules. Were any disciplinary proceedings framed against you, or had you been called upon to explain your conduct in any matter at the time you gave notice of termination of Service, or at a subsequent date, before your services were actually terminated.
13. (i)
Have you ever been arrested? Yes/ No
b) Have you ever been prosecuted? Yes/ No c) Have you ever been under detention? Yes/ No d) Have you ever been bound down? Yes/ No
e) Have you ever been fined by a Court of Law? Yes/ No
f) Have you ever been convicted by a Court of Law for any offence? Yes/ No
g) Have you ever been debarred from any examination or rusticated by any University or any other educational authority/institution? Yes/No
h) Have you ever been debarred/disqualified by any Public Service Commission from appearing at its
examination/selection? Yes/No i) Is any case pending against you in any law at the time of filing up this Attestation Form
Yes/ No
j) Is any case pending against you in any University or any other educational Authority/institution at the time of filling up this Attestation Form? Yes/ No
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 6 of 6
(ii) If the answer to any of the above mentioned questions is “Yes" give full particulars of the case/ arrest/ detention/ fine/ conviction/ sentence/ punishment etc. and/or the nature of the case pending in the Court/ University/ Educational Authority etc., at the time of filling up this Form.
NOTE : (i) Please also see the "warning at the top of this Attestation Form. (ii) Specific answer to each of the questions should be given by striking out Yes" or 'No' as the case may be.
i. Name and address of two responsible persons of your locality or two references to whom you are known:
Name Designation& Employer Address Phone Number
15. Details of UID /PAN/Passport Number (if Any) : a) Document Type
b) Number
I certify that the foregoing information is correct and complete to the best of my knowledge and belief. I am not aware of any circumstances which might impair my fitness for employment under Govt.
Signature of Candidate
Date:
Place:
CONFIDENTIAL (For Detailed Verification)
Attestation Form POWER SYSTEM OPERATION CORPORATION LTD. Page 7 of 6
IDENTITY CERTIFICATE
(Certificate to be signed by any one of the following)
i. Gazetted Officers of Central or State Government:
ii. Members of Parliament or State Legislature belonging to the constituency where the candidate or his
parent/guardian is originally resident:
iii. Sub-Divisional Magistrates/officer:
iv. Tehsildars or Naib/Deputy Tehsildars authorised to exercise magisterial powers.
v. Principal/Head-Master of the recognized School/College/Institution where the candidate studied last.
vi. Block Development Officer
vii. Panchayat inspector
viii. Post-Master
Certified that I have known Shri/Smt./Kumari ..........................-.................................................................................................................................................;. ................................................................................................. son/daughter of Sh..................................................................................................................................
for the last ................................................................................... years............................................................................... months and that to the best
of my knowledge and belief the particulars furnished by him/her are correct.
Place ...................... Signature
Date ......................... Designation. Status and Address
TO BE FILLED BY THE OFFICE
(i) ) Name, designation and full address of the appointing authority : POWER SYSTEM OPERATION CORPORATION LIMITED. Corporate Centre, B-9, Qutab Institutional Area, Katwaria Sarai, New Delhi-110016
(ii) Post for which the candidate is being
considered
(iii) Reference No. of Post