GOVERNMENT OF WEST BENGAL

OFFICE OF THE SUB-DIVISIONAL OFFICER

BARRACKPORE SUB-DIVISION
Memo No: 436/Con/Bkp Date 28.03.2023

NOTICE FOR ENGAGEMENT OF ASHA

On behalf of the ASHA Selection Committee, Barrackpore Sub Division applications are hereby
invited in the prescribed form (Annexure A) from the prospective and interested candidates for
engagement as Accredited Social Health Activist (ASHA) on purely voluntarily basis under NHM
for different areas under the Health Sub-Centers (Annex-C) under Barrackpore-I &
Barrackpore-II Blocks under Barrackpore Sub Division, in pursuance of the Memo No.
HFW/NRHM-20/2006/(Part-II)/1631, dated 27/06/2012 of the Mission Director, National
Health Mission, Health & Family Welfare Department, Government of West Bengal. Vacancy
Details is enclosed in Annexure-C

Date & Time of submission of application from : 28.03.2023 to 10.04.2023 from

11:00 a.m to 03:00 p.m on all working days except Saturday, Sunday and other Govt.
holidays.
Venue of submission of application form: Office of the Block Development Officer,
Barrackpore-I & Barrackpore-II Block.

Eligibility Criteria for engagement to the post of ASHA:

+ Should be a married/divorced/ widowed woman.
+ Should be a permanent resident of the same service area for which she will be selected
under the health sub-centre.
•. As on 28.03.2023 should be within the age group 30-40 years. In case of SC/ST
candidates, the lower age limit may be relaxed to 22 years. (For unreserved candidates
born not before 28-03-1983 and not after 28-03-1993; for SC/ST candidates born not
before 28-03-2001 and not after 28-03-1983).
+ Should be Madhyamik or equivalent examination appeared, candidates possessing higher
qualification are also eligible. However, in all cases (appeared and failed or passed or
possessing higher qualification) only the marks obtained in Madhyamik or equivalent
examination will be considered.
•• Areas where the majority of the population belongs to SC/ST, preference will be given to
candidates from that category, in consonance with vide Memo No. HFW-
27011/375/201 8-.NHM SEC-Dept. of H&F W-Par-II-3 692 Date: 03-12-2021.
+ Preference will be given to Grade I & Grade II SHG Members/ trained Dais/Link workers,
keeping the selection criteria fixed.
•' The address of eligible candidates will be verified physically.
How to apply:

Prospective and interested candidates should fill up prescribed application form (Annexure-A)
in her own hand writing with blue/black pen and enclose the following document:
4 Birth Certificate or Admit Card of Madhyamik of equivalent Examination (self attested
photocopy) as proof of age.
• Voters Identity card (EPIC), Aadhar Card and Ration Card (Self attested photocopy) as
proof of local residence.
+ Mark sheet of Madhyamik or equivalent Examination (Self attested photocopy), even in
case of failure in exam.
4 Self Attested copy of Marriage Registration Certificate in case of married women or self
attested copy of Decree of Divorce in case of Divorced women or self attested copy of
Death Certificate of Husband in case of widow.
+ In case of above mentioned Certificates (Marriage Registration Certification, Decree of
Divorce) are not available, Self Declaration regarding marital status certified by
E.A/Secretary and Health Supervisor of concerned G.P in Annexure B.
+ If applicable, SC/ST Certificate from competent authority (Self attested photocopy).
+ If applicable, in case of Grade I & Grade II SHG Members certificate from BDO,
Barrackpore-I & Barrackpore-II and in case of trained Dais/Link workers, certificate
form BMOH, Barrackpore-I & Barrackpore-II has to be submitted along with application
form.
•• Two (02) copies of identical recent Passport size colored photo, one for application form
and another for Admit Card.
+ A blank envelope (Size: 23cm X 10cm) with postage stamp of Rs. 5/- affixed and
the full postal address of the Candidate written on.
4 The envelope containing the Application Form and enclosures should be superscripted as
"APPLICATION FOR ENGAGEMENT AS ASHA, name of the sub-center applied for
and name of Service area " and
should be addressed to and to be submitted preferably by hand or via Speed Post or
Registered Post to:

The Block Development Officer

Development Block.
At B.D.O Office
At P.0- P.S.-
Dist: North 24 Parganas, PIN
•• Application by Whatsapp/e-mail/BDO office drop box shall not be entertained.
+ Application received via speed post or registered post after the schedule date of
submission shall not be entertained.
•. Incomplete/erroneous application / unsigned application! application without any or all
of the required documents shall be summarily rejected, and no consideration in this
regard shall be allowed.
+ Application received after 03:00 pm on 10.04.2023 will not be entertained.
9 Application received after due date and time due to postal delay of any other reason will
not be considered.
9 Interview will be held for the applicants fulfilling all criteria. The notice of date, time
and venue of the interview will be sent to the applicant via post. The details will also be
available at Barrackpore-I & Barrackpore-II Block office, Barrackpore-I & Barrackpore-II
all Gram Panchayat Offices and Health Centers under Barrackpore-I & Barrackpore-II
Block.
4 While applying the applicant should ensure that she fulfills the eligibility & norms and
that the particulars furnished by her are correct in all respects, In case it is detected at
any stage of selection that applicant does not fulfill any eligibility norms and or that she
has furnished any incorrect/false information or has suppressed any material fact(s), her
candidature will stand cancelled with no further communication. If any of these
shortcomings is/are detected even after selection her engagement is liable to be
terminated without assigning any reason thereof.
9 The ASHA selection Committee, Barrackpore Sub Division will draft panel list Sub Centre
wise on the composite number of Marks in Madhyamik Examination and Interview.
+ If any candidate fails to appear before the Interview board, her candidature will be
summarily rejected even if she is otherwise eligible and has secured highest marks.
+ Engagement of ASHA is purely on voluntarily basis and this does not confer any
right/privilege for regular appointment or continuity service.
9 Misconduct on the part of the candidate at any stage of the engagement process is
strictly prohibited & shall render disqualification.
9 The applicant shall not possess adverse Criminal Record which may render her
unsuitable for the post.
+ The original documents (except self Declaration with Certificate by EA/Secretary and
Health Supervisor of concerned Gram Panchayat regarding marriage and Certificate
regarding Grade-I/Grade-Il/Trained Dias/Link Workers) need not to be submitted.
9 The self attested copy of the certificates will be checked /verified with the original copy
during the interview.
+ Hence the qualified/short listed applicants will be asked to bring the original documents
during interview or consequently for verification of self attested documents.
General Conditions:
1. Carefully read the instructions mentioned above before applying. Fill up Application Form with due
care.
2. Help Desk has been set up at the Barrackpore-I & Barrackpore-II BDO Office. Apart from this, the
Gram Panchayats/RH/BPHCs/PHCs/Health Sub Centers under Barrackpore-I & Barrackpore-II
Development Block has been briefed, too. They may be approached.
3. Submission of the application does not guarantee an appointment.
4. In case of any misrepresentation of facts and documents the applicant shall be disqualified at any time
and at any stage during the process of selection appropriate legal action may be taken against the
candidate.
5. The Sub Divisional Level ASHA Selection Committee reserves the right to alter the mode of
examinations or to conduct re interview or to cancel part of whole of any process of engagement
including provisions/clauses of this notice or application at any stage, if required.
6. Beware of touts & job racketeers trying to deceive you by false promise(s) of securing job as "ASHA"
either through influence or by use of unfair means. Please beware of unscrupulous elements and do
not fall in their trap. Any attempt on the part of candidate to be selected by unfair means request
through persons, officials or agencies etc. will disqualify her candidature.
7. The decision of ASHA Selection Committee, Barrackpore SD will stand fmal.

Meier-crethry
ASHA Selection Committee
Barrackpore Sub Division
&
Sub Divisional Officer
Barrackpore Sub Division

Memo No. 436/1(12)/Con/Bkp Date 28.03.2023

Copy forwarded for information and taking necessary action to:-

1. The District Magistrate, North 24 Parganas, Barasat

2. The Additional District Magistrate (L & LR), North 24 Parganas, Barasat
3. The C.M.H.O., North 24 Parganas, Barasat
4. The A.C.M.O.H., Barrackpore
5. The Savapati, Barrackpore - I Panchayat Samity
6. The Savapati, Barrackpore -II Panchayat Samity
7. The Block Development Officer, Barrackpore - I Development Block with a request to publish the
Notification in your office and all the G.Ps. under your jurisdiction
8. The Block Development Officer, Barrackpore - II Development Block with a request to publish the
Notification in your office and all the G.Ps. under your jurisdiction
9. The B.M.O.H., Barrackpore-I with a request to publish the Notification in your office and all the
Health Institutions under your jurisdiction
10. The B.M.O.H., Barrackpore-II with a request to publish the Notification in your office and all the
Health Institutions under your jurisdiction
11. The SDICO, Barvackpore with a request to publish the said Notification in News papers
12. The D.I.O., NIC with a request to upload the said Notification in the District Website

Mem r-Set'
ASHA SelctIon Committee
Barrackpore Sub Division
&
Sub Divisional Officer
Barrackpore Sub Division
 Annexure-A
APPLICATION FORM for ASHA-2022
(Please fill the application form in CAPITAL LETTERS in own handwriting with Black/Blue Ball point pen)

To
For Office Use only The Member Secretary ASHA Selection Committee,
Received on - Sub Divisional Officer, Barrackpore,
- I- _/2023 Paste self
North 24 Parganas, West Bengal attested recent
Index No: colour passport
size
Sub : Application for engagement as ASHA photograph of
Roll No:
Ref : Notice Vide Memo No.: Dated the applicant

Name in fullS
Date of Birth Age as on 28.O3.2O23 Years Months Day
(As per Madhyamik Admit Card)
D D M M Y Y Y Y

Name of the Sub Centre applied for: Service Area applied for
Marital Status: (Please write "Yes' in the appropriate box) Married: Divorced: Widowed:
Husband's Name:

Father's Name

Address : Village G.P P.O

P.S District State Pin
Distance of house from the Sub-Centre (in Kms)
Category: SC ST General OBC
SC/ST Certificate No (if applicable) Ration Card No Aadhaar No
Occupational Details: , Contact No.
Details of Madhyamik or equivalent examination:
Year of
Name of Total Marks of Total Marks % of Marks
Appearance / Board / Council
Examination the Exam Obtained obtained
Passing
Madhyamik or
equivalent
Examination

Details of Experience (if any)

Enclosures 1) Birth Certificate or Admit Card of Madhyamik or equivalent Examination (Self attested photocopy)
2) Voters Identity card (EPIC), Aadhar and Ration Card (self attested photocopy)
3) Marksheet and Admit card of Madhyamik or equivalent Examination (self attested photocopy)
4) Marriage Certificate/Decree of Divorce/Self Declaration on Marital Status(in Annexure-B) certified by
EA/Secretary and Health Supervisor of concerned Gram Panchayat.
5) If applicable SC/ ST Certificate (Self attested photocopy)
6) If applicable Certificate from appropriate authority in case of Grade I & Grade II SHG Members and trained
Dais/Link -workers.
Declaration: I have read carefully the notice and understood it fully. I do declare that all the statement made on
this application are true complete and correct to the best of my knowledge and belief. In the event of the above
information being found false/incorrect at any stage my candidature is liable to be cancelled forthwith. This is also
to certify that I have no criminal record anywhere and if any criminal record is found my candidature will be
summarily rejected even if I get selected for the post. I am fully aware that the engagement is purely Contractual
and Temporary and I shall not claim for permanent engagement by virtue of this in future.
Place: -
Date : / / Full Sign2ture of the Annlicnt
 Annexure-B

Self-declaration by the applicant for her marital status (Married! Divorced! Widow).

I, Smt. D/O, W/O

am applying for the post of ASHA for (service area) under (sub centre)

I hereby declare that:-

1) I am a resident of

2)1 am married to Shri Sb

resident of for the last years

OR

3)1 am widow of late Sb

resident of who expired on

OR

4) I am separated from my husband Shri

S/ for the last years

This is true to the best of my knowledge arid belief and I have not suppressed any facts while giving the

above declaration.

Date

Place: Full Signature of the applicant

This is to certify that the above-mentioned information has been verified and it is true to the best of my
knowledge.

Signature of the Health Supervisor Signature of Executive Assistant / Secretary

Seal of the Gram Panchayat Seal of the Gram Panchayat

RECEIPT OF APPLICATION FORM OF ASHA

Application for recruitment of ASHA for Sub-Centre, service area is

received from Smt. of Vill.
P.O. , G.P. on at

For Block Development Officer,

Barrackpore - I / Barrackpore - II Development Block
 Block wise ASHA vacancy details under Barrackpore Sub-Division

Barrackpore-I Block
Afl,ioxij nC - -- -
Vacancy OotaiI I AS iA,.!.:toii I? 23.24 District North 24 Parganas
— i___ Selection
Total No of process
Name of Name of Name of Sub Name of Name of Service Populationol PreItrence Additional not
NO. No of VOcancy
Block GP Centre Village area thiS Service Category Vacancy FY 23. initiated
area 24 previous
BARRACKP .ETIA
JETIA JETIA JETIA 1188 UR 1 0
ORE-I BAKULTALA
BARRACKP JETIA
2 JETIA JETIA JETIA 1190 UR I 0
OREI NATUNPARA
BARRACKP JHILPAR &
JErIA BALIEHARA BALIBHARA 1120 Un I 0
ORE-I ITKHOLA - - --
BARRACKP JADUNATHB SUTRADHARPAR
JETIA NANNA 1150 UR I 0
ATI A
PURBAPARA.MA
BARRACKP
JETIA BIZNA BIZNA THPARA,KATHU 1098 UR I 0
- PARA

BARRACKP MAMUDP BHABAGAC BHAaAGACHI

6 BHABAGACHI 960 UR I 0
ORE-I UR HI DAKKHIN PARA
BARRACKP MAMUOP BHABAGAC BHABAGACHI
OHABAGACHI 940 UR 1 0
ORE-I UR HI MAJHER PARA
DAKKHIN
BARRACKP MAMUOP GHOSH
OOGACHIA DOGACHIA 904 UR I 0
PARA,JUGPUKU
R PARA
MOROLPARA.BE
BARRACKP SNIBDAS NEBOT
SALIDAHA SALIDAHA 907 UR 1 0
ORE-I PUR TALA.UTTAR
ATISARA
BARRACKP OCAWGAC KAWGACHI .11
PALTAPARA BAISALI - 1189 UR I 0
ORE-I Hl.II GP(HO)
HANUMAN
BARRACKP KAWGAC KHUDIRAMNAG ADARSAPAL MANOIR NEAR
1150 UR I 0
ORE-I HI-I AR LV SUBRATA
SARKER HOUSE
OARRACKP KAWGAC KHUOIRAMNAG KHUOIRAMN
12 HARISABHA 1183 UR 1 0
ORE-I HI-I AR AGAR
EARRACKP NAWGAC KHUDIRAMNAG BIBEKNAGA
13 SIMULTALA 1125 UN I 0
ORE-I HI-I AR R
RADHA KRISHNA
OARRACKP KAWGAC KHUOIRAMNAG BIBEKNAGA
14 MANOIRCAMBAG 1175 UN 1 0
ORE-I HI-I AR N
AN)
GARH DASPARA.JHILP
OARRACKP KAWGAC VIVEKANANOAG
SHYAMNAG ARA.GHOSHPAR 1195 Un - 1 0
ORE-I HI-I ARH
AR2 A
GARH
BARRACKP KAWGAC VIVEKANANDAG NATUNPALLY,VI
SHYAMNAG 1118 UR 1 0
ORE-I Ill-I ARH VEKNAGAR
AR2
I3ARRACKP SANTINAGA
JETIA MALANCHA RAMPUR 1094 SC 0 I
ORE-I R
BARRACKP KAWGAC KHUDIRAMNAG KHUOIRAMN VIVEKNAGAR I
18 1120 UN 0 I
- ORE-I HI-I AR AGAR ISUNDARBON)
BARRACKP KAWGAC VIVEKANANDAG VIVEKANAN VIVEKANANDAG
19 1135 UN 0 I
ORE-I Hl.I ARK DAGARH ARK
BARRACKP KAWGAC RAMMOHANPAL RAMMOHAN BARISTERBAGA
20 924 - UN 0 I
ORE-I HI-I LV PALLY N
BARRACKP KAWGAC RAMMOHANPAL RAMMOHAN NETAJIPALLY
21 1050 UN 0 I
ORE-I HI-I LV PALLY NIMTOLA
16 5 21

._sji.*ee.4enutive

Block Medicai Officer of He!th

Nanna B.P.H.0 ,Bl.24S
 • Annexure.0
• rn FY flitrict North24
Total No of Selection
Populationof Preference Additional pmcns Tot No of
SI. No. Name of Block Name of GP Name of Sub Centre Name of Village Name of Service ama not Vacancy
this Service Category Vacancy FY
area 23-24 initIated

BARRACKPORE II MOHANPUR MOHANPUR SADAR JAFFARPUR CT VIVEK NAGAR 1013 UR I 0 I

2 BARRACKPORE II MOHANPUR JAFFARPUR KAUTALA JAFFARPUR CT PURBA RABINDRAPALSY 1145 UR 0 I

3 BARRACKPORE II MOHANPUR CI-IAKKATHALIA CHAKKATHALIA CT MODHAPARA 1160 UR 0 I

4 BARRACKPORE II MOHANPUR CHAKKATHALIA CHAKKATHAIIA CT SUR VAS E N PALL V 1165 UR 0 I

$ BARRACKPORE II MO HAN P U R BOROKANTI-IALIA CHAKKATHALIA CT SARASWATIPALLY 1175 UR 0 I

6 BARRACI<PORE II SEWU TEIJNIPARA TELINIPARA BANSHPARAGHO5HPARA 1003 UR 0

7 BARRACKPORE II SEWU SURYAPUR NAVARAND NAVARAND 973 UR 0 I

8 BARRACKPORE II PATULIA RUIA RUIA NAUR MAT H 1187 UR 0 I

9 BARRACKPORE II PATULIA PATULIA SADAR PATU LIA SADURBAGAN,MILON NAGAR 1195 UR 0 I

10 BARRACKPORE II PATULIA DAN GAO IC H ILIA DANGADIGHILIA DANGADIGHILIA UTTARPARA 1145 UR 0 1

I 3O!BII -31odI3ELI
RUIA
11 BARRACKPORE H P AT U LIA RUIA PASCHIMPARA MONDALPARA 1005 UR 0 1
PASCHIMPARA
RUIA
12 BARRACKPORE II PATULIA RUIA PASCHIMPARA RUIA PASCHIMPARA,MONDALPARA UR 0 I
PASCHIMPARA

13 BARRACKPORE II PATULIA AN AN DANAGAR ANANDANAGAR BID HAN PAL LV 1195 UR 0 I

VIVEKANADAPALLY, MAHADEVER
14 BARRACKPORE II BANDIPUR BAN DIPUR BAN DIP UR 1142 UR 0
ART

15 BARRACKPORE II BANOIPUR BANOIPUR BAN DIPUR BANDIPUR DENTIA 1087 Un 0 I

16 BARRACKPORE II BAN DIPUR BALAGARH BALAGARH BALAGARH 1177 UR 0 1

17 BARRACKPORE II BANOIPUR THAKUR COLONY THAKUR COLONY THAKUR COLONY 1160 UR 0 1

18 BARRACKPORE II MURAGACHA TEGHARIA BIDHANPALLY, VIVEKANANOAPALLY UR 0

19 BARRACKPORE II TEGHARIA TEGHARIA WEST 1195 UR 0

20 BARRACKPORE II BILKANOA II LENINGARH TECH COLLEGE LEN IN GARH LENINGARH 6 BLOCK 1179 SC 0

21 OARRACKPORE II BILKANOA II SUBHAS SANGHA LENINGARN LENINGARH F BLOCK 1113 SC 0

22 BARRACKPORE II BILKANDA II SUBHAS SANGHA LENIN GARI-I LENINGARH 0 BLOCK 820 SC 0 I

TOTAL 18 4 22

Signatore of BMO Ite Her RefyeenIsIvo

POCK MEDICAL OFFICER OF - EALTH

BAJACKPORE M.00K-Il
BONOIPUR B.P.HC.
VA-TITAGARH, 24 PGS. I