EMPLOYEES’ STATE INSURANCE CORPORATION

MODEL HOSPITAL
(Under Ministry of Labour & Emplyment, Govt of India)
Rajajinagar, Bangalore – 560 010

No: 532/A/12/15/1/2010 DATE: 04/10/2010

RECRUITMENT OF STAFF NURSE

1. Applications are invited in the prescribed format for filling up the Staff Nurses
vacancies at ESIC Model Hospital, Rajajinagar, Bangalore – 560 010.

2. The details of the vacancies are :

Break up of Recruitment Position

SNo Name of Post Pay Scale Ex-
SC ST OBC UR Total
Servicemen
PH

PB – 2
1 Staff Nurse Rs.9300 – 34800 6 3 14 24 47 12 2
+ Grade Pay Rs.4600

Vacancies are likely to change depending upon the actual requirement.

Educational & Other Technical Qualifications, Age for the posts of Staff Nurse:
Essential
(a) Matriculation.
(b) Registered Nurse and Midwife or equivalent for the Male Nurse
(c) Age not exceeding 35 years.

Relaxation in age
a) 05 years in case of SC/ST candidates.
b) 03 years for Other Backward Classes recognized by the Govt. of India.
c) In case of Physically Handicapped 10 years
d) In cases of Ex.-Servicemen, service rendered in the Armed forces plus 03 years.
e) Age relaxation of 5 years will be available to the Govt. Employees and employees
of the Corporation as per rules.

B. Fee & Mode of Payment:-

General and Other Backward Class candidates shall submit DD for Rs.125/- towards
application fees and postal charges.

SC/ST/Ex-serviceman/PH/woman Candidates shall submit DD for Rs. 25/- (Rupees

twenty five only) towards postal charges.

Departmental candidates are exempted from payment of fees subject to enclosing

certificate of service from the ESI Hospital/ Dispensary.

The fee is required to be paid by all the candidates through Demand Draft issued in
favour of ESI Corporation payable at State Bank of India, Rajajinagar V Block
Branch, Bangalore -10.
The Demand Draft may be drawn on or after the date of publication of advertisement
payment in other form will not be accepted.
 .

C. Examination Centre – Written examination (Objective type) and interview

shall be held in Bangalore.

D. Instructions to candidate – How to apply:

1. The crucial date for reckoning the age will be 30/11/2010 being the last date for
receipt of applications.

2. The application in the prescribed proforma given below duly filled in English or
Hindi language, duly supported with clear/ legible attested copies of the relevant
certificates and marks statements (in English or Hindi) should be sent by
Registered post / Speed post suitably subscribed as “APPLICATION FOR THE
POST OF STAFF NURSE “to the following address:-

The Medical Superintendent,

ESIC Model Hospital,
Rajajinagar,
Bangalore – 560 010.

3. Candidates have to fill in the application form in their own handwriting with blue or
black ball point pen.

4. Original documents / certificates should not be sent with application.

5. The candidate should submit one application only in an envelope. The candidature
of those candidates who submit more than one application is liable to be rejected.

6. Envelope containing the application should be super scribed “Application for the
post of Staff Nurse 2010.” One envelope should contain one application only.

7. The initial place of posting will be Bangalore. However, incumbents are liable to be
transferred anywhere in India, as and when required.

8. Applications not in the prescribed proforma as appended below OR incomplete

(without photograph also) applications OR unsigned applications OR applications
received after the last date of the receipt of applications OR without required
enclosures are liable to be rejected and no reason for rejection will be
communicated.

9. The applications not in accordance with the above mentioned instructions are
liable to be rejected.

10. The candidates already in Govt. Service must specifically mention the details
of employment and should submit their application Through Proper Channel.
However, they may send an advance copy of their application alongwith
Demand Draft, other certificates and testimonial so as to reach this office on or
before the last stipulated date for receipt of application.

11. Mere submission of application does not confer any right on the candidates to be
called for examination or interview.
12. No interim correspondence/ enquiry will be entertained.

13. Last date of receipt of application is 30/11/2010. ESI Corporation will

not be responsible for postal delays.

14) No TA shall be paid to any candidate including SC/ST candidates for appearing
in the written examination. TA shall be paid to SC/ST candidates for interview
only as per Govt. of India orders.

15) The application form can be downloaded from Website:

www.esickar.gov.in

E. Mode of Selection: Open competitive examination (Objective type) or Interview

or both.

F. Documents required to be attached with the application:-

1. Attested photocopies of certificates in support of (1) Date of Birth (2) Educational

and Technical Qualification certificates (alongwith marks statements) (3) Caste
certificate (4) Discharge Certificate in case of Ex.-Servicemen (5) Disability
certificate in case of Physically Handicapped candidates.

2. Two Recent pass port size photograph duly attested by Gazetted Officer. One
photo should be firmly pasted (not stapled or pinned) in the space provided in the
application form.

3. NOTE: Demand Draft:

(a) The Demand Draft should not be tagged or stapled, but should be pinned or
clipped at the top of the application form.
(b) Fee once paid will not be refunded under any circumstances.
(c) Candidate must write his/her name and address on the back of the Demand Draft.

Caution: Canvassing in any form will be a disqualification.

MEDICAL SUPERINTENDENT, ESICMH, BANGALORE

 SN-APPN- PAGE-1
APPLICATION FOR THE POST OF STAFF NURSE
Paste your recent
passport size
(Centre for written exam / interview will be at BANGALORE) photograph
attested by a
Group “A” Gazetted
Officer

01. Name in full (in Block letters) :

02. Father’s/ Husband’s Name :

03. a) Amount of fee :
b) Demand Draft No. :
c) Name of issuing Branch :

04. Date of Birth (in Christian era) :

(In figures and in words)

05. Are you a citizen of India by

birth and / or domicile? :

06 Permanent Address
(in Block letters)
(with Pin Code Number)
Phone No. if any :

07. Mailing Address

(in Block letters) :
(with Pin Code Number)
Phone No. if any :

08. Category SC/ ST/OBC/General :

WITH DETAILS:

09. Whether Ex. Serviceman (Yes/ No) :

10. (a) Whether P.H. (Yes/ No) WITH DETAILS :

(b) If P.H. %age of disability :
 SN-APPN- PAGE-2

11. Educational & Technical qualifications (From Matriculation onwards):-

S Examination University / Subject Percentage of Year of
No Passed Board Marks obtained Passing

12. Experience / particulars of previous and present employment:-

S Name & full address Designation / Scale of Pay Period of employment
No of Employer Duties of post From To

13. Details of other academic and professional achievements and extra curricular
activities (if any):

14. Employment Exchange Regn. No. (If any) :

15. List of enclosures: - 1. 4.

2. 5
3. 6.

Declaration

I do hereby declare that all the statements made in this application are true,
complete and correct to the best of my knowledge and belief. I also declare that I
have submitted one application only. I am fully aware that in the event of any
particulars or information furnished by me is found to be false/ incorrect/incomplete or
for indulging in some unlawful act, my candidature for the post is liable to summarily
be rejected / cancelled and in the event of any statement / information submitted
found false/ incorrect even after my appointment, my services are liable to be
terminated without any notice.

Date: Signature of the candidate

Place: Name: