bjhl¡f¡ fšé Ïa¡ff« 2017-2018 M« fšéah©L¡fhd Cuh£Á x‹¿a / efuh£Á / khefuh£Á / muR bjhl¡f k‰W« eLãiy¥ gŸë jiyik MÁça® / g£ljhç / Ïilãiy / cl‰fšé MÁça®fŸ bghJ khWjš nfhU« é©z¥g« x‹¿a¤Â‰FŸ



X‹¿a« é£L x‹¿a« (kht£l¤Â‰FŸ)



kht£l« é£L kht£l«



(bghU¤jkhdj‰F  F¿æ£L¡fh£Lf) 1.

MÁçaç‹ bga® (jiy¥bgG¤ij filÁæš F¿¥ÃlΫ) NAME IN ENGLISH (Write in Block Letters)

(Initials at End)

2. ghèd« 3. ifngÁ v© 4. Ãwªj nj j‰nghJ gâòçÍ« gjé 5. (g£ljhç MÁça® våš ghl« F¿¥ÃlΫ) 6.

j‰nghija gjéæš Kj‹ Kjèš gâæš nr®ªj ehŸ

7.

j‰nghJ gâòçÍ« gŸëæš gâæš nr®ªj ehŸ bghJ khWjš  kdbkh¤j khWjš 

Ï¥gŸë¡F khWjš bg‰w Kiw 8.

neuo ãakd« 

(bghU¤jkhd x‹¿‰F k£L« F¿ælΫ)

gjé ca®Î  ã®thf khWjš  gâ ãutš

j‰nghJ gâòçÍ« gŸëæ‹ bga® : 9.

x‹¿a«

:

kht£l«

: 1



10. Áw¥ò K‹Dçikæ‹ mo¥gilæš khWjš nfhçdhš mj‹ étu« (cça rh‹¿jœfŸ) Ïiz¡f¥glnt©L«. rh‹¿jœ ÏUªjhš k£Lnk Áw¥ò K‹Dçik¡F¥ gçÓè¡f¥gL« (bghU¤jkhd x‹¿‰F k£L« F¿ælΫ)

01.06.2013 01-06-2014

1.

01.06.2016 - ¡F¥ Ë fzt‹ / kidé ég¤Ânyh mšyJ nehŒthŒg£nlh ÏwªÂUªjhš (Ïwªj ehŸ )



2.

K‰¿Y« f©gh®ita‰nwh®

 

ÏUja kh‰W mWit Á»¡ir (Heart Transplantation Surgery), ÁWÚuf kh‰W mWit Á»¢ir 01.06.2011-¡F¥ Ë brŒjt®fŸ (Kidney Transplantation Surgery), k‰W« ilahèÁ° Á»¢ir (Dialysis) (mWit Á»¡ir brŒa¥g£l ehŸ nk‰bfh©LtUgt®fŸ _______________ ) 4. fLikahf gh¡f¥g£l ò‰W nehahë 5. ÏuhQt¤Âš gâòçÍ« gâahsç‹ kidé 6. éjit / 40 taij¡ flªj ÂUkz« brŒJbfhŸshj K® f‹åa® 7. 40 % k‰W« mj‰F nkY« Cd« 11.06.2011 cŸs kh‰W¤ Âwdhë 8. 40 % k‰W« mj‰F nkY« kdts®¢Á F‹¿a k‰W« kh‰W¤ Âwdhë FHªijæ‹ bg‰nwh® 9. j‰nghJ gâòçÍ« gŸëæš 01.06.2014¡F K‹ gâ V‰wt®fŸ 10. fzt‹ / kidé ika / khãy muR mYtyf« / muR rh®ªj mYtyf« / muR / cjé bgW« gŸëæš gâòçt®fŸ 11. 2016-17fšéah©oš gâãutš k‰W« gjé ca®Î bg‰wt®fŸ 3.

5.

9. 10.

11.

flªj 2016-2017 M« M©L bghJ khWjš fyªjhŒéš fzt‹ / 11. kidé ÏUtU« gâòçgt®fŸ v‹w mo¥gilæš khWjš bg‰wt®

M« / Ïšiy

é©z¥gjhu® gâòçÍ« Ïl¤ÂèUªJ fzt‹ / kidé 12. gâòçÍ« kht£l« k‰W« Ïl¤Â‹ öu« (».Û.)

kht£l« : ».Û.

2

:

    

 



MÁçaç‹ cW bkhê nkny F¿¥Ãl¥g£LŸs étu§fŸ mid¤J« c©ikbad cW TW»nw‹. eh‹ F¿¥Ã£l étu§fŸ jtW vd f©l¿a¥g£lhš v‹ ÛJ Jiw rh®ªJ

nk‰bfhŸs¥gL«

bjçé¤J¡bfhŸ»nw‹.

xG§F nkY«,

elto¡if¡F eh‹

nfhU«

c£gLnt‹ Ïl¤Â‰F

vd

khWjš

tH§F«g£r¤Âš v›éj khWjš gaz¥goÍ« nfhukh£nl‹ vd cW më¡»nw‹. Ïl« : ehŸ :

MÁça® ifbah¥g«

nk‰f©l étu§fŸ mid¤J« rh®ªj MÁça® Kj‹Kjèš gâæš nr®ªj ehŸ, j‰nghJ gâòçÍ« gŸëæš gâæš nr®ªj ehŸ, k‰W« neuo ãakd« / bghJ khWjš / kdbkh¤j khWjš / gjé ca®é‹ _y« khWjš / ã®thf khWjš M»at‰iw gŸë¥ gÂntL x¥Ã£L

k‰W«

Ïju

Mtz§fnshL

rçahf cŸsJ v‹W rh‹wë¡f¥gL»wJ.

ehŸ :

jiyikahÁçaç‹ ifbah¥g« nk‰f©l étu§fŸ mid¤J« rh®ªj MÁça® Kj‹Kjèš gâæš

nr®ªj ehŸ, j‰nghJ gâòçÍ« gŸëæš gâæš nr®ªj ehŸ, k‰W« neuo ãakd« / bghJ khWjš / kdbkh¤j khWjš / gjé ca®é‹ _y« khWjš / gâãutš / ã®thf khWjš M»at‰iw gâ¥gÂntL Mtz§fnshL

x¥Ã£L

rçahf

cŸsJ

k‰W«

Ïju

v‹W« m‹dh® ÛJ jäœehL

FoKiwgâ (xG§FKiw k‰W« nkšKiwpL) éÂfŸ 17(a) k‰W« 17(b)-‹ go v›éj xG§F elto¡ifÍ« ãYitæš Ïšiy v‹W« rh‹wë¡f¥gL»wJ. nkY« Áw¥ò K‹Dçik¡fhd rh‹¿jœfŸ rçgh®¡f¥g£lJ vd rh‹W më¡f¥gL»wJ. ehŸ : cjé / TLjš cjé¤ bjhl¡f¡ fšé mYty®

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