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Office of the Principal
Administration

Office of the Principal

Faculty administrative services, prescribed forms and document checklists—organised around the task you need to complete.

Frequently Used Forms

Direct access to forms most commonly required by faculty and the Principal's Office.

KYF

Know Your Faculty

WBMES proforma for faculty particulars, service history, academic details and institutional verification.

SERVICE & CAREER · PDF / DOCX
NPA

NPA / Private Practice

Government circular, NOC application and WBMES option form for eligible personnel.

NOC & PERMISSIONS · PDF
ViewComing soon

Administrative Services

The definitive service directory. Filter by category, then open a service to view requirements, notes and prescribed forms.

Before you apply

For every application, submit a plain-paper application stating the issue and justification/ground, along with service particulars in Annexure I (“Doctors Personal Details” / “Know Your Doctor”) and the service-specific documents listed below.

  • Use the latest prescribed form and complete all applicable fields.
  • Sign/date the application and attach the listed supporting documents.
  • Obtain HOD/competent-authority verification or recommendation wherever applicable.
  • Submit through the appropriate administrative channel.

Note: Applicable Government rules, orders and subsequent amendments shall prevail.

Prescribed annexures and forms for these services are being finalised for upload. Buttons marked Coming soon will become active download links once the documents are published here.

Service & Career
New Joining of Faculty
Starting point for joining formalities

For newly joining faculty, use this service as the institutional starting point for joining-related documentation. The relevant resources available on this page include Know Your Faculty (KYF), Charge Handover / Taking Over where applicable, and other service forms.

Additional institution-specific joining documents can be added here when finalised.
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1. Confirmation of Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure II.
  2. Photo copy of Appointment Order.
  3. Photo copy of Joining letter with acceptance from competent authority.
  4. Photo copy of receipt for Submission of Assets Declaration for last 3 years.
  5. Photo copy of receipt for Submission of ACR/SAR for first 3 years.
  6. Attested Photo copy of Page 02, 03 & 04 of Service Book of the applicant.
Download the prescribed Annexure; the other items are supporting documents.
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Know Your Faculty (KYF) — WBMES
Information to be furnished

The Know Your Faculty (KYF) proforma is for faculty of the West Bengal Medical Education Service (WBMES) and records faculty identity, service history, academic particulars and institutional verification.

  1. Personal & professional particulars — full name, discipline, present designation, gender, category, date of birth and Medical Council registration details.
  2. Service particulars — dates of joining WBHS/WBMES and feeder post, employee details, present place of posting and date of confirmation of service.
  3. Posting history — designation, discipline, place of posting and period of service, including feeder post/detailment as applicable.
  4. Academic details — degree/diploma, discipline, university, DNB training centre/other academic details, attempts and year of passing/publication of result as provided in the form.
  5. Spouse posting faculty details — where applicable, faculty name, registration number, designation, discipline/department, place of posting, employee ID and mobile number.
  6. Declaration & institutional verification — applicant declaration/signature and verification from the Service Book by the Head of the Institute.
The prescribed proforma states that it should not be modified; additional information, if needed, may be provided on separate sheets.
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Charge Handover / Taking Over — Form 2403
What this form records

West Bengal Form No. 2403, with reference to Rule 61 of the West Bengal Rules Vol. I, is used for formal delivery and receipt of charge at Deben Mahata Government Medical College & Hospital.

  1. Date & time of handover/taking over — the day and time at which charge is delivered and received.
  2. Office / Department — the office and department at DMGMCH, Hatuara, Purulia.
  3. Government Order reference — relevant G.O. number and date.
  4. Relieved officer — signature, name in block letters, designation and department.
  5. Relieving officer — signature, name in block letters, designation and department.
  6. Office processing — place where the appointment order was received, DMGMCH memo/date and countersigned forwarding particulars.
Use the prescribed form for formal delivery and assumption of charge.
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Transfer & Posting of Faculty
Faculty service

Prescribed application for transfer and posting of teaching faculty through proper channel.

This is an additional faculty service resource and is not part of the numbered 1–20 services in the 15.09.2021 circular.

15. Counting of Adhoc Service Period towards Pensionary Benefit
Required documents
  1. Duly filled up Proforma enclosed in Annexure XVI.
  2. Photo copy of Adhoc Appointment order.
  3. Photo copy of Adhoc Joining order.
  4. Photo copy of order regarding extension Adhoc engagement time to time.
  5. Photo copy of order for Regularisation of Adhoc service.
  6. Photo copy of Service Confirmation order.
  7. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
  8. Scan copy of Service Book.
Download the prescribed Annexure; the other items are supporting documents.
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CAS & Pay Progression
5. CAS on Completion of 8 Years Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure VI.
  2. Photo copy of Appointment Letter.
  3. Photo copy of Joining letter with acceptance.
  4. Photo copy of regularisation of Adhoc service if initial appointment is on adhoc basis.
  5. Photo copy of Service confirmation Order.
  6. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  7. Photo copy of order in respect of sanctioning EOL, if any.
  8. Photo copy of order in respect of “Dies-non” or “Break-in-service”, if any.
  9. Photo copy of order in respect of pending DP, if any.
  10. Photo copy of receipt for submission of ACR/SAR for last 5 years prior to date of completion of 8 years.
  11. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
N.B.: The Original completed ACR or Acknowledgement slip for submission of SAR, as the case may be, for last 5 years prior to date of completion of 8 years regular service in respect of the applicant should be submitted with the application (in sealed cover in case of ACR). The required ACR/SAR should be initiated from the part of the applicant and to be submitted to the Reporting Officer, who subsequently should complete the respective part and forward it to the Reviewing Officer, who thereafter should forward it to the Accepting Authority after completion of his/her part. The Reporting Officer and Reviewing Officer should be aware regarding their responsibilities for completion of ACR/SAR of the Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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6. CAS on Completion of 16 Years Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure VII.
  2. Photo copy of Appointment Letter.
  3. Photo copy of Joining letter with acceptance.
  4. Photo copy of regularisation of Adhoc service if initial appointment is on adhoc basis.
  5. Photo copy of Service confirmation Order.
  6. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  7. Photo copy of order in respect of sanctioning EOL, if any.
  8. Photo copy of order in respect of pending DP, if any.
  9. Photo copy of receipt for submission of ACR/SAR for last 5 years prior to date of completion of 16 years.
  10. Photo copy of order of awarding benefit of CAS on completion of 8 years service.
  11. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
N.B.: The Original completed ACR or Acknowledgement slip for submission of SAR, as the case may be, for last 5 years prior to date of completion of 16 years regular service in respect of the applicant should be submitted with the application (in sealed cover in case of ACR). The required ACR/SAR should be initiated from the part of the applicant and to be submitted to the Reporting Officer, who subsequently should complete the respective part and forward it to the Reviewing Officer, who thereafter should forward it to the Accepting Authority after completion of his/her part. The Reporting Officer and Reviewing Officer should be aware regarding their responsibilities for completion of ACR/SAR of the Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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7. CAS on Completion of 25 Years Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure VIII (a), VIII (b) & VIII (c).
  2. Photo copy of Service confirmation Order.
  3. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  4. Photo copy of order in respect of sanctioning EOL, if any.
  5. Photo copy of order in respect of “Dies-non” or “Break-in-service”, if any.
  6. Photo copy of order in respect of pending DP, if any.
  7. Photo copy of receipt for submission of ACR/SAR for last 5 years prior to date of completion of 25 years.
  8. Photo copy of order of awarding benefit of CAS on completion of 16 years service.
  9. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
N.B.: The Original completed ACR or Acknowledgement slip for submission of SAR, as the case may be, for last 5 years prior to date of completion of 25 years regular service in respect of the applicant should be submitted with the application (in sealed cover in case of ACR). The required ACR/SAR should be initiated from the part of the applicant and to be submitted to the Reporting Officer, who subsequently should complete the respective part and forward it to the Reviewing Officer, who thereafter should forward it to the Accepting Authority after completion of his/her part. The Reporting Officer and Reviewing Officer should be aware regarding their responsibilities for completion of ACR/SAR of the Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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Leave, Absence & Study
8. Regularisation of Absent Period in Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure IX.
  2. Photo copy of Resumption order.
  3. Photo copy of Joining letter with acceptance.
  4. Photo copy of documents in support of cause of absent.
  5. Photo copy of Service confirmation Order.
  6. Leave Admissibility Report as on the date on which the incumbent lastly attended duties before remaining absent from duties.
  7. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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9. Resumption of Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure X.
  2. Photo copy of Appointment order at the place from which the applicant remained absent from duties.
  3. Photo copy of Joining letter at the place from which the applicant remained absent from duties.
  4. Photo copy of documents in support of cause of absence, if any.
  5. Photo copy of Service Confirmation Order.
  6. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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13. Sanction of Study Leave
Required documents
  1. Duly filled up Proforma enclosed in Annexure XIV.
  2. Photo copy of initial Appointment order.
  3. Photo copy of initial Joining order.
  4. Photo copy of NOC for appearing in the Entrance Examination through which the applicant is selected to undergo further study.
  5. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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17. Joining as MO on Study Duty
Required documents
  1. Duly filled up Proforma enclosed in Annexure XVIII.
  2. Photo copy of Order in respect of placement on TR.
  3. Photo Copy of Joining report on TR.
  4. Photo copy of Release order.
Download the prescribed Annexure; the other items are supporting documents.
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NOC, Permissions & Personal Matters
NPA / NOC for Engagement in Private Practice
Eligibility & requirements

For teaching faculty of West Bengal Medical Education Service and Medical Officers of West Bengal Health Service who are not drawing Non-Practicing Allowance (NPA) and have opted for private practice. NOC from the Director of Medical Education or Director of Health Services, as applicable, is required before engaging in private practice.

  1. Employee particulars, as per KYC.
  2. Government order of posting at present place of employment.
  3. Copy of application for surrendering NPA.
  4. Date of Joining in Service.
  5. Mobile Number.
  6. Email ID.

Practice conditions: Private practice may be undertaken only after obtaining the NOC, within a 20 km radius of the place of posting, and not in Government premises or Government quarters.

Coming soon
The PDF includes the prescribed NOC application and the WBMES Option Form (Annexure-I).
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Declaration of Assets — West Bengal Form No. 34A
What this form covers

West Bengal Form No. 34A records the officer’s particulars and declaration of assets as they stood on the stated date. The prescribed form provides separate schedules for immovable and movable property.

  1. Officer / service particulars — name, service, designation and pay particulars as provided in the prescribed form.
  2. Immovable property — including land, houses and immovable property of other description / rights.
  3. Movable property — including cash, bank balance, credit, insurance policies, shares, debentures and other movable assets covered by the form.
  4. Ownership / acquisition particulars — the schedules provide for value, the name in which the asset is held, date and manner of acquisition and remarks, as applicable.
  5. Declaration & signature — complete the applicable schedules and sign the prescribed declaration.
Use the prescribed West Bengal Form No. 34A. Complete the applicable fields and schedules in the form.
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3. Permission for Purchase of Vehicle
Required documents
  1. Duly filled up Proforma enclosed in Annexure IV.
  2. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  3. Photo copy of Current Pay Slip.
  4. Photo copy of Proforma Invoice.
  5. Documents in support of source of finance for purchase of the vehicle:
    1. Current Bank Statement for Salary Saving.
    2. GPF/PPF current statement and loan sanctioned order for GPF/PPF Loan.
    3. Loan sanctioned order from Bank for Bank Loan.
    4. Declaration in Stamp Paper of relatives for loan from relatives.
  6. Attested Photo copy of Page 02, 03 & 04 of Service Book of the applicant.
Download the prescribed Annexure; the other items are supporting documents.
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4. Permission for Purchase / Sale of Land / House / Flat
Required documents
  1. Duly filled up Proforma enclosed in Annexure V.
  2. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  3. Photo copy of Current Pay Slip.
  4. Photo copy of Valuation Certificate.
  5. Photo copy of Agreement Deed.
  6. Documents in support of source of finance for purchase of the Property:
    1. Current Bank Statement for Salary Saving.
    2. GPF/PPF current statement and Loan sanctioned order for GPF/PPF Loan.
    3. Loan sanctioned order from Bank for Bank Loan.
    4. Declaration in Stamp Paper of relatives for loan from relatives.
    5. Loan sanctioned order for House Building Loan.
  7. Attested Photo copy of Page 02, 03 & 04 of Service Book of the applicant.
Download the prescribed Annexure; the other items are supporting documents.
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10. Declaration in Connection with Foreign Visit
Required documents
  1. Duly filled up Proforma enclosed in Annexure XI.
  2. Photo copy Identity Card.
  3. Photo copy PAN Card.
  4. Photo copy EPIC Card.
  5. Photo copy Aadhar Card.
  6. Photocopy of initial Appointment letter.
  7. Photo copy of Service Confirmation order.
  8. Photo copy of Joining report at present place of posting.
  9. Photo copy of Passport.
  10. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  11. Photo copy of Up to Date Saving Statement of Bank Account.
  12. Photo copy of On Line Leave Application.
  13. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
  14. Consent of the Officer who will perform the duties of the applicant during his/her period of leave granted for Foreign visit.
  15. Certificate from the Controlling Authority/Head of the Office stating that no other Medical Officer serving in the same Department of the Institution has applied for any kind of leave during the period for which the applicant sought permission for foreign visit and thus hospital service will not be hampered if permission is granted.
Download the prescribed Annexure; the other items are supporting documents.
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11. NOC for Passport
Required documents
  1. Duly filled up Proforma enclosed in Annexure XII.
  2. Photo copy Identity Card.
  3. Photo copy PAN Card.
  4. Photo copy EPIC Card.
  5. Photo copy Aadhar Card.
  6. Photocopy of initial Appointment letter.
  7. Photo copy of Service Confirmation order.
  8. Photo copy of posting order at present place of posting.
  9. Photo copy of Joining report at present place of posting.
  10. Photo copy of Passport (for renewal of passport).
  11. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  12. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
  13. 3 copies of recent Passport sized Photo.
  14. Self Declaration regarding Nationality on Non Judicial Stamp Paper of Rs 10/-.
    Proforma for Declaration: “I Dr. .................................................... Son/Daughter/Wife of ...................................................., presently posted as Medical Officer at ...................................................., presently reside at ...................................................., am hereby declare that I am citizen of India by birth.”
    Date ____________________     Full signature ____________________
Download the prescribed Annexure; the other items are supporting documents.
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12. Change of Surname
Required documents
  1. Duly filled up Proforma enclosed in Annexure XIII.
  2. Photo copy of Upgraded Registration Certificate of WBMC.
  3. Photo copy Identity Card/Aadhar/PAN/EPIC Card having desired Surname change.
  4. Photo copy of Marriage Registration Certificate.
  5. Affidavit from 1st Class Magistrate in support of desired change in Surname.
  6. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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Cadre / Career Movement
14. Submission of Technical Resignation
Required documents
  1. Duly filled up Proforma enclosed in Annexure XV.
  2. Photo copy of Appointment order of existing Cadre.
  3. Photo copy of Joining order of existing Cadre.
  4. Photo copy of Permission for appearing in interview for new post under new cadre obtained.
  5. Photo copy of Appointment order in new Cadre.
  6. Attested Photo copy of pages 02, 03 & 04 of Service Book of Applicant.
Download the prescribed Annexure; the other items are supporting documents.
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16. Joining as MO on Technical Resignation (TR)
Required documents
  1. Duly filled up Proforma enclosed in Annexure XVII.
  2. Photo copy of Order in respect of placement on TR.
  3. Photo copy of Charge Handover Order.
  4. Photo copy of Release order.
  5. Photo copy of execution of Bond for TR.
  6. Photo copy of Money Receipt for admission in Institution where allowed to undergo the course.
Download the prescribed Annexure; the other items are supporting documents.
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18. Opt In from WBHS to WBPHAS
Required documents
  1. Duly filled up Proforma enclosed in Annexure XIX.
  2. Photo copy of Appointment order in existing Cadre.
  3. Photo copy of Joining order in existing Cadre.
  4. Photo copy Confirmation order.
Download the prescribed Annexure; the other items are supporting documents.
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19. Opt Out from WBPHAS to WBHS
Required documents
  1. Duly filled up Proforma enclosed in Annexure XX.
  2. Photo copy of Appointment order in existing Cadre.
  3. Photo copy of Joining order in existing Cadre.
  4. Photo copy Confirmation order.
Download the prescribed Annexure; the other items are supporting documents.
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Exit from Service
2. Resignation from Service
Required documents
  1. Duly filled up Proforma enclosed in Annexure III.
  2. Photo copy of order for confirmation of service.
  3. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  4. Photo copy of documents in support of reasons, if any, for which resignation has been sought.
  5. Attested Photo copy of Page 02, 03 & 04 of Service Book of the applicant.
Download the prescribed Annexure; the other items are supporting documents.
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20. Submission for Volunteer Retirement
Required documents
  1. Duly filled up Proforma enclosed in Annexure XXI.
  2. Photo copy of order for confirmation of service.
  3. Photo copy of receipt for submission of Assets Declaration for last 3 years.
  4. Attested photo copy of Page 02, 03 & 04 of Service Book of the incumbent.
  5. Photo copy of documents, if any, in favour of cause on which VR sought.
Download the prescribed Annexure; the other items are supporting documents.
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Forms & Downloads

A searchable document repository for users who already know which form they need.

Form / DocumentRelated ServiceFormatDownload
Annexure II — Proforma for Application for Confirmation of ServiceService & CareerPDF↓ Download
Know Your Faculty (KYF) ProformaService & CareerPDF↓ Download
Know Your Faculty (KYF) — EditableService & CareerDOCX↓ Download
Transfer Application ProformaService & CareerPDF↓ Download
Charge Handover / Taking Over — Form 2403Service & CareerPDF↓ Download
Declaration of Assets — Form 34ANOC & PermissionsDOCX↓ Download
NPA / NOC for Private Practice — Application & Option FormNOC & PermissionsPDFComing soon
Important Documents — Land Purchase & Other Service MattersNOC & PermissionsPDFComing soon

Need help with a service or form?

For clarification regarding the appropriate form, supporting documents or submission procedure, please contact the Office of the Principal.

Office of the Principal
Deben Mahata Government Medical College & Hospital
Hatuara, Purulia, West Bengal

Email: prinpuruliagmch@gmail.com
Hatuara Help Desk: 7501304309
Office Hours: Monday–Friday, 10:00 AM–5:00 PM
(Except Government Holidays)