Certificate

+É®úÉäMªÉ ʴɦÉÉMÉ, ÊVɱ½þÉ {ÉÊ®ú¹Énù ºÉÉiÉÉ®úÉ

EòɪÉÉÇ±ÉªÉ nÖù®úv´ÉxÉÒ – (02162) 233 VÉÉ.Gò +É®úÉäMªÉ/+ɺlÉÉ-1/ /13
025ù ÊVÉ.{É. ºÉÉiÉÉ®úÉ ÊnùxÉÉÆEò
EòɪÉÉÇ±ÉªÉ ¡òìCºÉ Gò. – (02162 ) 230399

Form of certificate to be submitted by Departmental candidates

(To be filled by the Head of the Institution/ Office served by the candidate)

It is certified that Dr. Tejswi Ramchandra Patil is working in primary Health Centre Morgiri Tal- Patan as a
Medical Officer.
2. Her total experience is as follows:
Sr Period Appointment Order No. with Nature of Name & Address Pay Last Pay
No. From – to date Appointment Of Institute Scale Drawn
1 25/08/2008 =ºÉ+ɺÉä/+ɺlÉÉ/]àõ Ad-hoc Primary Health 8000-
To Centre Morgiri 13500
24/07/2009 1/¨É´Éè+ɺÉä/+/32670,73/08 Ênù Tal-Patan
04/08/2008
2 29/07/2009 ¨É´Éè+ɺÉä/|É.Gò.121/ Ad-hoc Primary Health 15600-
To Centre Morgiri 39100
28/06/2010 {ÉÖxÉÇ ÊxɪÉÖEòiÉÒ/EòIÉ-2 Tal-Patan
+/9926-31/2009
Ênù 03/12/2009
3 1/07/2010 =ºÉ+ɺÉä EòÉä/¨É´Éè+ɺÉä/2 +/ Ad-hoc Primary Health 15600-
To Centre Morgiri 39100
31/05/2011 +ºlÉÉ<Ç/´Éè+ÊxÉ/ 13542-46 Tal-Patan
Ênù 1-07-2010
4 3/06/2011 =ºÉ+ɺÉä EòÉä/¨É´Éè+ɺÉä/2 +/ Ad-hoc Primary Health 15600-
To Centre Morgiri 39100
2/05/2012 +ºlÉÉ<Ç/´Éè+ÊxÉ/ 13590-95 Tal-Patan
still working Ênù 30-05-2011
5 5/5/2012 To =ºÉ+ɺÉäEòÉä/¨É´Éè+ºÉä/|ÉGò Ad-hoc Primary Health 15600-
4/4/2013 Centre Morgiri 39100
178/{ÉÖxÉÇ ÊxÉ/EòIÉ 2 +/9970- Tal-Patan
74/2012 Ênù 17-5-2012
6 8/4/2013 To =ºÉ+ɺÉäEòÉä/¨É´Éè+ºÉä/|ÉGò Ad-hoc Primary Health 15600-
30/08/2013 Centre Morgiri 39100
178/{ÉÖxÉÇ ÊxÉ/EòIÉ 2 +/b÷Éì Tal-Patan
{ÉÉ]õÒ±É/ 12092-96 Ênù 10-5-2013
3.It is also certified that there is no Disciplinary / Vigilance or any other case is pending or
contemplated against Dr. Tejaswi Ramchandra Patil and her integrity is beyond doubt.
4 No major/minor penalties have been imposed on her during her Service.
5. Certified that the exact dates of break given in her service is from 25-07-09 To 28-07-09, 29-06-10
To 30-06-10, 1-06-11 To 02-06-2011, 3-5-12 to 4-5-12, 6-4-13 To 7-4-13.
Certified that the above mentioned experience posses by the employees is as per the office record.

Place: Satara: Signature

Date: Name
Designation:
Contact No.: