BY RPAD

MEDICAL EDUCATION DEPARTMENT

From To
Prof.Dr.G.Anitha,MD., The Director of Medical Education,
Dean Kilpauk,
Mahatma Gandhi Memorial Chennai-10
Govt.Hospital Tiruchirappalli-17

Ref. No.9377/ E4/2017 dt .01.18

Sub: Nursing Establishment-Mahathma Gandhi Memorial

Govt.Hoslpital, Trichy-Tmt.M.Rajeswari, Nursing
Superintendent Gr-II – Due to Retire on
Superannuation on 31.01.2018AN Permission to
relieve her from Government Service-Requested-
Regarding.
-------
I submit herewith the Proposals for Superannuation
Retirement (Due on 31.01.2018 A.N) in respect of Tmt.M.Rajeswari,
Nursing Superintendent Gr-II of this Hospital for your kind perusal and
necessary action.

I request you to kindly grant permission to relieve

her from Government Service on the After Noon of 31.01.2018.

RETIREMENT PROPOSALS ARE

1. Complete Service Particulars
2. Proforma form to be filled by Forwarding Authority
3. No Dues/No Disciplinary Proceedings Pending Certificate
4. Declaration of the individual in Green Bond Paper (4 copies)
5. Ref.No.7034/E1/17 dt.05.12.17 of the Dean,
Govt.Thiruvarur Medical College Hospital, Thiruvarur
6. Ref.No.348/A/17 dt.21.12.17 of the Superintendent,
Govt.Rajaji T.B Hospital, Trichy

DEAN
 SERVICE PARTICULARS OF TMT.M.RAJESWARI, NURSING
SUPERINTENDENT GR-II MAHATHMA GANDHI MEMORIAL
GOVT.HOSPITAL, TRICHY-17

1 Name and Designation Tmt.M.Rajeswari

Nursing Superintendent Gr-II
2 Institution to which attached Mahathma Gandhi Memorial
Govt.Hospital, Trichy
3 Date of Birth 06.01.1960
4 Date of Joining in Govt.Service 06.09.1984 FN
5 Date of Regularization 06.09.1984 FN
6 Date of Completion of Probation 06.09.1986 AN
7 Date of Superannuation 31.01.2018 AN
Post held and stations which worked

Sl. Post Name of the Institution From To

N
o
1 Staff Nurse Tirunelveli Medical 06.09.1984 FN 28.02.1986 AN
College Hospital,
Tirunelveli
Transit Period 01.03.86 04.03.86
2 Staff Nurse Govt.Rajaji Hospital, 05.03.1986 FN 24.10.1987 FN
Madurai
EL on MC 24.10.87 27.10.87
Maternity Leave 28.10.87 21.01.88
4 Staff Nurse Govt. Head Quarters 22.01.1988 FN 31.07.1993 AN
Hospital, Trichy
Transit Period 01.08.1993
5 Staff Nurse Govt.Raja Mirasudar 02.08.1993 FN 22.08.2003 AN
Hospital, Thanjavur
6 Staff Nurse Annal Gandhi Memorial 23.08.2003 FN 30.04.2004AN
Govt.Hospital, Trichy
Staff Nurse Govt.Rajaji 01.05.2004 FN 24.06.2014 AN
T.B.Hospital, Trichy
Medical Leave 25.06.2014 15.07.2014

Nursing Govt.Tiruvarur Medical 16.07.2014 FN 31.12.2014AN

Superintendent College Hospital,
Gr-II Tiruvarur
7 Nursing Mahatma Gandhi 01.01.2015 FN Till Date
Superintendent Memorial
Gr-II Govt.Hospital, Trichy

DEAN
 ANNEXURE

PROFORMA FORM TO BE FILLED UP BY THE FORWARDING

AUTHORITY WHILE SENDING PROPOSALS FOR
SUPERANNUATION RETIREMENT

1 Name,Designation and Present Tmt.M.Rajeswari

Station of the retiring personnel Nursing Superintendent Gr-II
2 Date of Birth 06.01.1960
3 Date of First Appointment 06.09.1984 FN
4 Present Scale of Pay 15600-39100+5400 GP
5 Date of Retirement 31.01.2018 AN
6 Whether any disciplinary action Nil
is pending against the individual
as on Date? If so the pendency
at whose level may be
mentioned with Ref.No. and
date
7 Whether any disciplinary action Nil (No Due certificate enclosed)
is contemplated, If so, the
present Stage may be furnished
8 Whether any disciplinary action Nil (No Due certificate enclosed)
is disposed off and in such a
case the nature of punishment
imposed with Ref.No.and
Date.Please mention whether the
punishment period is over
9 Whether any Government dues Nil (No Due certificate enclosed)
are pending recoverable against
the Government Servant? If so,
the Details may be furnished.
10 Whether any audit recoveries are Nil (No Due certificate enclosed)
pending, If so, the details may
be Furnished
11 Whether advance intimation was Yes
sent to the individual regarding
her Retirement on attaining the
age of Superannuation

DEAN
 NO DUE CERTIFICATE(1)

Certified that no amount is pending towards

Bank/Society Loan to be recovered from Tmt.M.Rajeswari,

Nursing Superintendent Gr-II due to retire on Superannuation on

31.01.2018 AN and no House Building Advance

Recovery/Interest Recovery is pending to be recovered.

DEAN
 NO DUE CERTIFICATE(2)

Certified that Tmt.M.Rajeswari, Nursing

Superintendent Gr-II working at Mahathma Gandhi Memorial

Government Hospitla, Trichirappalli has not come across any

adverse remarks/No Disciplinary action is pending/contemplated

against her and also no Government money is pending to be

recovered from the individual and no Audit Para Pending in

respect of the above individual.

DEAN
 NO DUE CERTIFICATE(3)

1. Certified that she has not come across any adverse remarks/No
Disciplinary action is pending / contemplated against him at
this institution.

2. Certified that no Government money is due to be recovered

from her no long term loan is pending to be recovered from him
at this institution.

3. Certified that no leave period is pending to be regularized

against her at this institution.

4. Certified that no Audit para is pending to be settled against her

at this institution.

DEAN
 DECLARATION
RECOVERY CERTIFICATE AS PER G.O.MS.NO.845/FINANCE
DATED:12.3.1978

I, M.Rajeswari, Nursing Superintendent Gr-II

working at Mahathma Gandhi Memorial Govt.Hospital,

Trichy declare that the Government Money, if any due from

me or the loss caused to the Government by any overdrawn of

pay and allowances etc., by me and any other obvious dues as

a result of negligence or fraud noticed on my part while in

service may be recovered from the Death-cum-Retirement

Gratuity or Pension or Commutation of Pension or any other

amount due to me or by way of Revenue Recovery Act if

necessary in one lumpsum.

SIGNATURE OF THE INDIVIDUAL

/COUNTERSIGNED/
 DECLARATION

I, M.Rajeswari, Nursing Superintendent Gr-II do

hereby declare that No dues are pending to be recovered

towards the House Building Advance, House Building

Advance Interest, Society loan, Bank Loan, Motor Car/Motor

Cycle Advance etc., and if any found later may be recovered

from my Death-Cum Retirement Gratuity/ Pension in one

lumpsum.

SIGNATURE OF THE INDIVIDUAL

/COUNTERSIGNED/