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Government of the People’s Republic of Bangladesh

Directorate General of Health Services


Mohakhali, Dhaka-1212

Health Workforce Datasheet

Warning
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I agree I don’t agree

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Welcome to DGHS Personal Information Data Sheet
Click on the buttons below to enter or update your information
First
Personal Family Information on Educational Registration Posting, Transfer,
appointment &
Information Information Current Job Qualification Information Promotion
Regularization
Miscellaneous
Salary and Training Leave, Disciplinary Retirement &
DDOship & Audit (publications,
Benefits (Local & Foreign) Deputation, Lien actions Pension
others)
Mouse over will show type of information each button will accept
Personal Information
ID No. ...........................................
Code No. ...........................................
Name (in English): ................................................................. Permanent address
bvg (evsjvq)t .......................................................... Urban or rural area:
Sex: Male Female Urban (municipality or City Corporation) Rural
Father’s name: ................................................................ If urban, which town or city? (Choose from the list): ............
Mother’s name: ............................................................... Type the detailed address here:
Date of birth: ........(day) ...........(month) ..............(year) District (choose from the list): ........................................
Religion: Muslim Hindu Buddhist Christian Other Thana/Upazila (choose from the list): ..............................
Marital status: Unmarried Married Widowed Divorced Not divorced
but living separated Spouse died Post office: ..................................Postal code.....................
Village (or Road and House No.) .............................................
Present address Land phone (separate by , if more than 1): .............................
Date updated Mobile phone (separate by , if more than 1): ........................
Living in urban or rural area: Email address (separate by , if more than 1): .........................
Urban (municipality or City Corporation) Rural
If urban, which town or city? (Choose from the list): ............ Save Information
Type the detailed address here: ....................................................
District (choose from the list): ........................................
Thana/Upazila (choose from the list): .............................. Family Information
Post office: ..................................Postal code..................... Spouse information
Village (or Road and House No.) ............................................. Use a table to display following information:
Land phone (use , if more than 1): ................................... Sl. No. Your code:
Mobile phone (use , if more than 1): ............................... Date updated: Name of spouse:
Email address (use , if more than 1): ...................................... Does s/he currently serve under DGHS? Yes/No

1 | Personal Data Sheet


His/her code, if under DGHS His/her occupation (choose from list) Place of posting: ..............................................................................
His/her designation His/her place of posting (detail address) Type of the posting place:
His/her department/organization Remarks, if any Community Clinic Union sub-center Rural health center Urban
dispensary TB Clinic Leprosy clinic TB hospital Upazila Health
Complex District/ Sadar Hospital General Hospital Medical College
Medical College Hospital Postgraduate Teaching Institute (non-
clinical) Postgraduate Teaching Institute (Clinical) Infectious disease
Children’s information hospital DGHS Divisional Health Office CS Office Sadar Upazila
Use a table to display following information Health Office Other institute Trauma Center MATS IHT Nursing
Sl. No. Your code: Institute ....
Date updated: Name of child: Location of your posting place:
Date of birth: Sex: Urban or rural: Urban Rural
Schooling: Not started Studying Completed Stopped Name of thana/upazila (choose from list)
If schooling, level of education Name of district (choose from list)
Marital status: Unmarried Married Widowed Divorced Not divorced Date of joining in current post: .............(day) ......... (month) .......(yr)
but living separated Spouse died Pay scale of present post (choose from list)
Employment: Studying, does not earn Earns beside studying Full Basic pay in Taka:
time employment Unemployed Sick, not fit for Next increment date: .........(day).........(month)............(year)
employment Drawing salary from same post: Yes/No
Remarks, if any His/her occupation (choose from list) If not, mention from which post you currently draw salary:
His/her designation His/her place of posting (detail
address) Educational Qualification
His/her department/organization Type exactly your highest educational qualification................

Save Information Fill up this table


.................................................... Sl. Your Level of Actual Board/ Distinction, Major
Year Institute
No. Code education level University if any subject(s)
Choose Choose Choose
Information on current job
Your code:
Date updated: Explanation:
Type of post: Cadre Regular Regular Temporary Development Level of education:
Directorate: DGHS Nursing Illiterate Below primary Below junior Junior Below secondary Secondary
Higher Secondary Graduate Masters PhD Post-doctoral Undergraduate
Professional category (add a definition page):
DiplomaOther
Physician Dentist Nurse Midwife Pharmacist Engineer Total length of study: ..............years
Laboratory scientist Physiotherapist Medical technologist Actual level of education:
Technician Assistant to technician Environment and public health Illiterate Class I-IV Class V Class VI-VII Class VIII Class IX-X SSC HSC
worker Community health worker Traditional Medicine Practitioner BA/BSc/BCom/Fazil MA/MSc/MCom/Kamil MBBS BDS Undergraduate Diploma
(AMC practitioner) Birth attendant Medical Assistant Personal care (nursing, paramedical, medical assistant, etc.) Postgraduate diploma
worker Health management and support worker Other health MPhil/MD/MS PhD Post-doctoral
professional or worker
Professional sub-category (add a definition page):
Registration Information
First
Physician: General, Internal medicine, General surgery, Regulatory Degree Regis- Last
Sl. Your Regis-
Ophthalmology, etc. body registered tration Renewal
No. code tration
Dentist: General, maxillofacial surgery, Orthodontics, etc. (choose) (choose) No. Date
Date
Nurse: Professional nurse, auxiliary nurse (nurse aid), enrolled nurse,
dental nurse, primary care nurse, cardiac nurse, nurse-midwife, etc.
Midwife: Professional midwife, auxiliary midwife, enrolled midwife
Physiotherapist: if there is any sub-category
Medical technologist: Laboratory, Radiography, Physiotherapy, First appointment and Regularization
Radiotherapy, Dental, Sanitary inspector, Optometry, etc. Internship Training
Technician: Laboratory technician, dental technician, ECG technician, Type Date completed
etc.
Internship
Assistant to technician: Lab assistant, Dental assistant, Pharmaceutical day-month-year
or In-service Training
assistant, etc.
Environment and public health worker: Environment officers, Ad-hoc appointment, if any
Environment public health officers, Sanitary officers, Sanitation Ever appointed on
Date G.O. No. Serial No.
worker, Hygienist, Public health technician, malaria technician, ad-hoc basis?
meat inspector, public health supervisor, etc. Yes/No day-month-year
Community health worker: assistant/community health education
Has your job been regularized? Yes/No
worker, community health officer, family health worker, lady health
If yes, give particulars in following table:
visitor, health extension package worker, community midwife
For post Date of Serial
Other health workers: dietician, nutritionist, occupational therapist, Sl. No. Authority
(choose) regularization No.
operator of medical and dental equipment, optometrist, optician, Assistant Surgeon
podiatrist, prosthetic/orthetic engineer, psychologist, respiratory Assistant Professor
Associate Professor
therapist, speech pathologist, trainee Professor
Health management and support worker (non-medical): health MOHFW Assistant Director
manager, health economist, health statistician, teaching Deputy Director
1 PSC Director
professional, health policy lawyer, medical records and health DPC Additional Director General
information technician, ambulance staff, cleaning staff, building Director General
..............
and engineering staff, general support staff, driver Consultant
Designation (choose from list) Senior Consultant
Type of placement 2
Current charge In-charge Working Deputation Study deputation 3
OSD (working) OSD (punishment) Lien Against the post Fixed pay Service confirmation following BCS
Contract Service
Service confirmed BCS Batch No. G.O. No. Date
Remarks, if any: ...........................................
2 | Personal Data Sheet
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1

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2
1
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2
1
Sl. No. Sl. No.
Sl. No.

3
2
1
Sl. No.
Your Code
Your code Your code
Designation (choose)
Yes/NO

Name of training Course

Your
code
CourseName of training
Posted as (choose)

Foreign training (outside


Sponsoring organization

Salary and Benefits

Leave (except casual leave)


G.O. No.
Venue

Leave, Deputation, Lien


Date
when a

changed
began or
new scale
G.O. Date

Training (Local and Foreign)


Posting, Transfer, Promotion

3 | Personal Data Sheet


Venue Organized by

country)
G.O. Serial

the
Scale?
Country Begin date

What was

Local training (within country)


End date First Posting, Transfer in same rank, Transfer in higher
Begin date (choose)PunishmentPromotion, Demotion

Save Information
Save Information
Save Information

status,

pay?
the Basic
What was
End date Duration (days)

....................................................
....................................................
....................................................

Duration

Why
scale
Place of posting

changed
etc.Diploma, certificate,
etc.Degree, diploma, certificate,
Joining date

Remarks Remarks

Remarks
Release date

3
2
1
3
2
1
3
2
1

3
2
1
3
2
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Lien
Sl. No. Sl. No. Sl. No. Sl. No. Sl. No.

Your code Your code


Deputation

Your code
Your code
Your code Purpose of taking Lien list)Type of Deputation (choose from

list)Type of Leave (choose from


Year Length of approved Lien Length of approved deputation
outFinancial responsibility carried

Disciplinary actions
Length of approved leave
Date You started Lien on date You started deputation on date
If yes, where? You started leave on date

DDOship and Audit objection


Complain You joined after Lien on date You joined after deputation on date
You joined after leave on date
In what capacity?
You enjoyed Lien(length)
Inquiry Officer (length)You enjoyed after deputation

Save Information
Save Information
Save Information
You enjoyed leave (length)
Type of audit objection, if any deputationG.O. No. & date granting
Decision deputationG.O. No. & date granting

....................................................
....................................................

G.O. No. & date granting leave

Describe further If you fail to follow any condition of


Decision date Lien, explain why?
Purpose & outcome of deputation Purpose of taking leave

Remarks, if any What is the current status ?


Other Remarks, if any Remarks, if any
Remarks, if any
.................................................... Presentation
Your National or Scientific
Retirement and Pension Sl. No. Title Date, Venue, Country
code International or General
Regular date of LPR: ............(day) ............... (month) ............. (year) 1
Regular date of Pension: ................ 2
3
(day) ....................(month) ............... (year)
Type of
retirement
Your (Early/ Date Date of Reason for
Sl. No. Nominee
code Forced/ begins termination termination
LPR/
Pension)
1 Affiliation
2 Your Type of
Sl. No. Organization Position Remarks, if any
3 code Organization
1
Save Information 2
3
....................................................
Miscellaneous (Publication, presentation, affiliation, etc.)
Any other information
Publication Memo box
Authorship:
Your National or Original or
Sl. No. Title Principal or Reference
code International Review
Co-author
1
2 Save Information
3
....................................................
†Nvlbv
Avwg GB g‡g© †Nvlbv KiwQ †h, Avwg GB di‡g †Kvb wg_¨v ev fyj Z_¨ ‡`B bvB| Avgvi e¨w³MZ WvUvkx‡U
Z‡_¨i †Kvb wePz¨wZ cwijwÿZ n‡j ev †Kvb ¸iæZ¡c~Y© Z_¨ Abycw¯’Z _vK‡j Avwg `vqx _vK‡ev Ges KZ…©cÿ
GRb¨ Avgv‡K †h ‡Kvb kvw¯Í w`‡Z cvi‡eb|

I agree, Submit

4 | Personal Data Sheet


Annual Credential Report
Code No. ....................... Awareness about security:
Name: ............................................................... Behavior with people:
Designation: ..............................................................
Part IV: Work Performed
Part I : Report on Health Examination
Professional knowledge:
Quality of work:
Height: ......................... feet Quantity of work performed:
Weight: ........................ kilogram Ability of monitoring and directing
Vision: .......................... Relation with colleagues
Blood Group: O:........... Rh: .................. Competence for decision making:
Blood Pressure: Systolic ................ Diastolic ................... Ability for decision implementation:
X-ray report: ..................................................................... Interest and ability to train subordinates:
ECG Report: .................................................................... Ability of expression (written):
Medical Type: .................................................................. Ability of expression (verbal):
Health problem/ Fitness problem: ................................... Initiative to complete ACR and taking countersign:
Health Officer who signed ................................................ Sincerity:
Total No. obtained: Extraordinary Excellent Best Average
Date: .....................................
Below average
Part II : Biodata Part V: Written Sketch about the officer on assessment
Grading on assessment (between 1 and 4)
Additional information that is missing in PDS
Competence in foreign language:
Speaking
Reading
Writing
Length of service under the officer who is writing this Part VI: Recommendations
ACR: .......................... Months/ Years
Performance of the staff during this ACR period Special preference/qualification (administrative, official,
a. external, other):
b. Honesty and reputation:
c. Moral
Intellectual
d.
Material
e. Recommendations for on-job promotion
Part III: Personal Characteristics Fit for promotion
[Grade 1 to 4) Not yet fit for promotion
Discipline: Reached highest level for promotion
Judgment and sense of limit (jurisdiction): Recently promoted; premature for new promotion
Intelligence: Other recommendation (if any):
Pro-activeness and initiative:
Personality: Name of assessor: ...............................................
Cooperativeness:
Punctuality: Designation: ................................................
Dependability: ID No. ...............................................
Responsibility:
Interest to work: Date: ...............................................
Performance to taking action and carry out order of superiors:

5 | Personal Data Sheet

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