National Institute of Diseases of the Chest & Hospital
Mohakhali, Dhaka-1212, Bangladesh
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To be filled in by the scrutinizer
1. 2yrs. after MBBS/BDS/M.Sc.: Yes/No / 7. 2 yrs. after end of
2. Length of Govt. Service / last deputation : Yes/No
· Revenue / 8. Requisite papers : Yes/No
· Project / 9. If No, What is lacking :
3. Requisite training : Yes/No / (see overleaf) :
4. If no, what is lacking / 10. Any comment :
5. Prior deputation : Yes/No
6. Result of exam. during
Last deputation : Pass/Fail / ELIGIBLE / NOT ELIGIBLE
Signature and Name of the scrutinizer:
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