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    Medical Education Department, Govt. of Rajasthan HR Management - Master Data Form For UTB

    Uploaded by

    Shiv singh
    This document contains a master data form for UTB (Unitary Teaching Board) members in the Medical Education Department of Rajasthan. The form collects personal details such as name, designation, category, address, contact information, as well as academic details including degrees earned and publications. Applicants must fill out the form in capital letters and provide details of their first joining as a UTB member such as date, name of college, and post. They must also declare that the information provided is true and binding.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Medical Education Department, Govt. of Rajasthan HR Management - Master Data Form For UTB

    Uploaded by

    Shiv singh
    60 views3 pages
    This document contains a master data form for UTB (Unitary Teaching Board) members in the Medical Education Department of Rajasthan. The form collects personal details such as name, designation, category, address, contact information, as well as academic details including degrees earned and publications. Applicants must fill out the form in capital letters and provide details of their first joining as a UTB member such as date, name of college, and post. They must also declare that the information provided is true and binding.

    Original Description:

    Medico

    Original Title

    Raj

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    This document contains a master data form for UTB (Unitary Teaching Board) members in the Medical Education Department of Rajasthan. The form collects personal details such as name, designation, category, address, contact information, as well as academic details including degrees earned and publications. Applicants must fill out the form in capital letters and provide details of their first joining as a UTB member such as date, name of college, and post. They must also declare that the information provided is true and binding.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    60 views3 pages

    Medical Education Department, Govt. of Rajasthan HR Management - Master Data Form For UTB

    Uploaded by

    Shiv singh
    This document contains a master data form for UTB (Unitary Teaching Board) members in the Medical Education Department of Rajasthan. The form collects personal details such as name, designation, category, address, contact information, as well as academic details including degrees earned and publications. Applicants must fill out the form in capital letters and provide details of their first joining as a UTB member such as date, name of college, and post. They must also declare that the information provided is true and binding.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Medical Education Department, Govt.

    of Rajasthan
    HR Management – Master Data Form for UTB

    RAJ-MEDICO

    (All THE DETAILS MUST BE FILLED VERY CLEARLY IN CAPITAL LETTERS )

    Personal Details

    Salutation Dr. / Mr. / Mrs. / Ms. (Tick the appropriate one)

    Name ………………………………………………………..

    Father’s Name ………………………………………………………..

    Marital Status Married / Unmarried / Divorcee / Widow (Tick the appropriate one)

    Spouse’s Name ………………………………………………………..

    Date of Birth ………………………………………………………..

    Gender Male / Female / Third Gender (Tick the appropriate one)

    Category General / SC / ST / OBC / SBC (Tick the appropriate one)

    Designation Medical officer / Senior Demonstrator / Assistant Professor (Tick the

    appropriate one)

    Whether in Regular Govt Yes / No


    Service

    Aadhar No. ……………………………………………………….

    RMC Registration No. ……………………………………………………….

    Mobile No. ……………………………………………………….

    E-mail ID ……………………………………………………….

    Present Address ……………………………………………………….

    ……………………………………………………….

    ……………………………………………………….

    Permanent Address ……………………………………………………….

    ……………………………………………………….

    ……………………………………………………….
    Bank Name (Salary A/c) ……………………………………………………….

    IFSC CODE BANK ACCOUNT NO

    Academic Details

    S.No. Name of Degree Name of Institute / College / Year of Batch RMC Reg.
    (MBBS / BDS / University Passing No.
    MD / MS / MDS /
    DM / MCh / PhD
    / MSc etc)
    1.

    2.

    3.

    4.

    First Joining as UTB in Medial Education Department

    Date of Joining ……………………………………………………….

    Name of College ……………………………………………………….

    Post ……………………………………………………….

    Cadre / Branch / Speciality ……………………………………………………….


    Update Publications : only RESEARCH ARTICLES should be mentioned ( Last 5 years )

    S. Title Name of Journal Month Authorship


    No & Year (First /
    . of Second /
    Publica Corresponden
    tion t / Et Al)
    1.

    2.

    3.

    4.

    5.

    Declaration:
    I do hereby declare that all the information given by me above is true, complete and correct to the best
    of my knowledge, is binding on me and nothing has been hidden by me. I will not claim any change or
    alteration.

    Signature………………..

    Name……………………………………………..

    Date……………………..

    Place……………………………………………..

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