One Hour

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DEPARTMENT OF NURSING SERVICES DEPARTMENT OF NURSING SERVICES

JIPMER HOSPITAL, PUDUCHERRY. JIPMER HOSPITAL, PUDUCHERRY.


APPLICATION FOR AVAILING ONE HOUR PERMISSION APPLICATION FOR AVAILING ONE HOUR PERMISSION

FROM DATE: FROM DATE:


Name of the Applicant (Mr. /Ms. /Mrs.) : Name of the Applicant (Mr. /Ms. /Mrs.) :
Employee No : Employee No :
Designation & Ward : Designation & Ward :
Nursing Section : I / II / III Nursing Section : I / II / III
To To
The Nursing Superintendent, The Nursing Superintendent,
Nursing Section-I / II / III, Nursing Section-I / II / III,
JIPMER hospital, JIPMER hospital,
Puducherry. Puducherry.
Through proper channel Through proper channel
Respected madam, Respected madam,

Kindly permit me to avail one hour permission on / / , Kindly permit me to avail one hour permission on / / ,
afternoon from 2:00pm to 3:00pm for my personal work. afternoon from 2:00pm to 3:00pm for my personal work.
Thanking You, Thanking You,
Yours Sincerely, Yours Sincerely,

Signature of the Applicant Signature of the Applicant


Signature of forwarding authority Signature of forwarding authority

SNO SNO Mob No :


Mob No :
ANS Mail Id : ANS Mail Id :

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