CENTRAL COUNCIL OF INDIAN MEDICINE New Delhi Schedule for scrutinizing Faculty Data base Forms for code number Sl. No. 1. 2. Name of the College Govt. Siddha Medical College, PALAYAMKOTTAI, Tirunelveli -627002, (TN) Govt. Siddha Medical College, Arignar Anna Hospital Campus, Arumbakkam, Chennai-106, (TN) Date To Be Scrutinized Faculty Data Base Forms For Coding 18.11.2014 19.11.2014 3. ATSVS Siddha Medical College, Munchirai, Kanyakumari-629171 (TN) 20.11.2014 4. Sri Sairam Siddha Medical College, Poonthandalam, West Tambaram, Chennai-44, (TN) 21.11.2014 5. Velumailu Siddha Medical College, Sriperumbudur, Kanchipuram-602105 (TN) 24.11.2014 6. Santhigiri Siddha Medical College, Santhigiri (PO),Pothencode, Thiruvananthapuram-695589 (KERALA) 25.11.2014 7. National Institute of Siddha, Tambaram Sanatorium, Chennai-47, (TN) 26.11.2014 8. RVS Siddha Medical College, 242-B, Trichy Road, Sulur, Coimbatore-641402 (TN) 27.11.2014 9. Sivaraj Siddha Medical College, Thumbathulipatty, SiddharKoil Main Road, Salem-636307 (TN) 28.11.2014 CENTRAL COUNCIL OF INDIAN MEDICINE 61-65, INSTITUTIONAL AREA, JANAKPURI, NEW DELHI- 110058. FACULTY DATA BASE FORM (Siddha) State College Name Recent photo duly signed by the teacher Full Name of Teacher Father’s a e Date of Birth Qualification UG(University & Year) PGSubject(University & Year) Any other (Ph.D.) Present Designation Present Department *Date wise details of Experience in chronological order (1st appointment to till date. Attach separate sheet if necessary) From To Designation Organization Name of the State Council/Board with Registration Number Present Address Permanent Address Contact Number E- Mail Mob: Res: Subject / Department It is certified that all information given by me is correct and true to the best of my knowledge. Signature of Teacher It is certified that …………………………………………………………………….is worki g as ……………………………………..……..in our College. The information furnished by him is true & factual to the best of my knowledge. Principal/Dean/Director (All columns should be filled up by the candidate only & in case any column remains unfilled, code number will not be issued) *Date wise details of experience in chronological order can be provided in separate sheet in the prescribed format duly signed by teacher. For office use only Code No. Signature of verification officer
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