Details related to A.N.M.

Public Information Officers

(Name of the Department)

(Office)

(Place)

Sub: Application under the RTI Act, 2005

Provide the following information related to the ANM working in the ……………. Gram Panchayat.

1. Provide the following regarding the ANM working in the above mentioned Gram Panchayat :

· Name

· Designation

· Date of taking charge in the Gram Panchayat

· Description of duties/responsibilities

· Time of reporting for duty daily

2. Provide a copy of the attendance register of the last 6 months of the said ANM.

3. Provide a list of the Immunisation and the medicine distribution done by the said ANM in the last one year with the following details:

· Name and address of the beneficiary/recipient

· Name of the medicine and dot/immunisation provided

· Date of provision of the dot/immunization

4. What action can be taken against the ANM if she does not do field visit of the village on time? Kindly provide a copy of the related rules/regulations and directions.

5. Provide a copy of complaint ( if any) against the said ANM for not being punctual or being absent from work with the following information:

· Name of the complainant

· Brief description of the complaint

· Date of complaint

· Description of the action taken on the complaint

· Name, designation and address of the officer who took action on the complaint

I am depositing the application fee (Rs. 10/-) separately/ I am a BPL card Holder, so, I am exempt from payment of fee. My BPL card no. ....................../

If you feel that above requested information does not pertain to your department then please follow the provisions of section 6(3) of the RTI Act, 2005. Also as per the provisions of the RTI Act, 2005 please provide the details (Name & Designation) of the first appellate authority w.r.t to your department with the reply to the above request. where I may if required, file my first appeal.

Thanking you,

Name:

Add.:

Phone No.: