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16436485675557 - 3 मातृत्व सुरक्षा योजनाको सुविधा दावी फारम

This document appears to be a form for claiming benefits under the Maternity Protection Act from the Social Security Fund. It requests information about the employer and employee, including personal details of the employee and pregnancy/childbirth details. The employee and employer must recommend and certify the accuracy of the information provided. Required documents like birth certificates must be attached. Certain conditions like sex selective abortion are noted as not qualifying for the benefit.

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aasishtiwari23
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0% found this document useful (0 votes)
39 views3 pages

16436485675557 - 3 मातृत्व सुरक्षा योजनाको सुविधा दावी फारम

This document appears to be a form for claiming benefits under the Maternity Protection Act from the Social Security Fund. It requests information about the employer and employee, including personal details of the employee and pregnancy/childbirth details. The employee and employer must recommend and certify the accuracy of the information provided. Required documents like birth certificates must be attached. Certain conditions like sex selective abortion are noted as not qualifying for the benefit.

Uploaded by

aasishtiwari23
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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cg';'"rL #

-sfo{ljlwsf] bkmf @^ v08 s ;Fu ;DalGwt_


dft[Tj ;'/Iff of]hgfsf] ;'ljwf bfjL kmf/d

!= /f]huf/bftfsf] ljj/0f
/f]huf/bftfsf] gfd M
/f]huf/bftfsf] ;"rLs/0f g+= M
7]ufgf M
k|b]z M lhNnf M
uf=kf÷g=kf÷pk=d=g=kf=÷d=g=kfM j8f g+=
Ans g+=
6f]n M

@= >ldssf] JolQmut ljj/0f


klxnf] aLrsf] clGtd
Gffd÷y/M
j}jflxs cj:yf M ljjflxt÷cljjflxt÷5'l§P/ a;]sf÷;DaGw ljR5]b÷Psn dlxnf
;fdflhs ;'/Iff g+=
uef{j:yf M ;'Ts]/L u/fpg] tf]lsPsf] ldlt
-c:ktfnsf] lrlsT;sn] tf]s] cg';f/_
;Gtfgsf] ;+Vof klxnf] aRrf bf];|f] aRrf t];|f] aRrf
-pd]/=========_ -pd]/=========_ -pd]/=========_
a}+s vftfsf] ljj/0f M
a}+ssf] gfd a}+s vftfsf] k|sf/
a}+ssf] 7]ufgf a}+s vftf gDa/

#= hGd÷;'Ts]/Lsf] k|sf/
-s_ hLljt hGd÷ d[t hGd M ============== -v_ ue{ ue{ktg M =======
-u_ ck/]zg÷;fdfGo ;'Ts]/L M ===========

$= k|;"lt ePsf] :yfg M


-s_ c:ktfnsf] gfd M ============================ lghL jf ;/sf/L =========================
-v_ gl;{ª\ xf]dsf] gfd -olb ;'Ts]/L u/fOPsf] xf] eg]_ M ======================================================
-u_ c:ktfn cyjf gl;{ª xf]d afx]ssf] 7fpFdf ;'Ts]/L u/fOPsf] xf] eg] 8fS6/sf] gfd M
=======================================
-3_ :jf:Yo :jo+d ;]ljsfn] ;'Ts]/L u/fPsf] eP :jo+d ;]ljsfsf] gfd M ================================
-ª_ cGo eP M
%= 3f]if0ff -of]ubfgstf{sf]_

dfly plNnlvt Joxf]/f 7Ls ;fFrf] xf] d}n] k|rlnt ;fdflhs ;'/Iff cg'?k g} ;'ljwf bfjL u/]sf] 5' . olb unt
;"rgf jf ljj/0f e]l6Pdf k|rlnt g]kfn sfg"g adf]lhd ;Fhfo ePdf d]/f] d~h'/L 5 .

>ldssf] gfd M ============= b:tvt M ============


ldlt M ===========

bfofF afofF

^= /f]huf/bftfsf] tkm{af6 l;kmfl/;

lghnfO{ dfly pNn]v ul/Padf]lhd cf}ifwL pkrf/ tyf :jf:Yo ;'/Iff of]hgf adf]lhd e'QmfgLsf] Joj:yf
ul/lbg'x'g cg'/f]w ub{5' .
l;kmfl/;stf{sf] gfd ========================================== kb M========================================
6]lnkmf]g g+= M =================================================== b:tvt M===========================
ldlt M====================================================
&= ;fdflhs ;'/Iff sf]ifn] k|dfl0ft ug]{

k|dfl0ft ul/Psf] /sd M ==============================

/sd e'QmfgL -cÍdf_ M ====================== /sd e'QmfgL -cIf/df_ M ===================

gfd M ========================================= kb÷tx M =================================

b:tvt M ==================================== ldlt M ================================

*= r]s ln:6

-s_ hGdbtf{ k|df0fkq


-v_ ;fdflhs ;'/Iff kl/rokq
-u_ lrlsT;ssf] k|df0f kq -c:ktfnn] lbPsf] k|df0f_
-3_ labfsf] k|df0f -sfof{noåf/f k|bfg ul/Psf]_

gf]6M
!= obL bfjL k|s[ofsf] qmddf ;fdflhs ;'/Iff sf]ifsf clwsf/LnfO{ e|d jf z+sf nfu] u'0f:t/ hfFr tyf
7uL lgoGq0fsf nflu k|f;+lus sDkgL uO{ lg/LIf0f ul/g]5 .
@= bfjL kmf/fd k"0f{ ?kdf el/Psf] x'g' kb{5 . cw'/f] jf pNn]v gul/Psf ;"rgfnfO{ sfo{Gjogsf] ÷;'ljwfsf]
bfo/fdf /flvg] 5}g .
#= g]kfndf cjl:yt s'g} klg sDkgL -/fli6«o, cGt/f{li6«o jf ax'/fli6«o_ df sfo{/t ljb]zLx¿sf]
/fhb"tfjf;n] hf/L u/]sf] kmf]6f] ;lxtsf] kl/ro kq lgo'Qmstf{n] a'emfpg' kg]{5 .
$= s'g} klg k|sf/sf] bfjL /sd e'QmfgL ug{sf nflu JolQmut ljj/0fdf cfkm\gf] a}+s ljj/0f k|i6 ?kdf
pNn]v ug'{kg]{ 5 .

alxis/0f tyf k|ltaGw


! grflxPsf] ue{df e|'0f{ xTofsf] cj:yf of] ;'ljwf nfu' x'g] 5}g . oBkL cfdfsf] Hofg nfO{ vt/f eO{
ul/Psf] ue{ktg h;nfO{ lrlsT;ssf] ;Nnfx cg';f/sf] k|df0f a'emfOPsf] v08df dfq} ;'ljwf bfjL ug{
kfOg]5 .
@= olb o; cl3 b'O{ ;Gtfgsf nflu ;'Ts]/L ;'ljwf k|fKt ul/;s]sf] cj:yfdf of]hgfn] t];|f] aRrfsf nflu
/sd k|bfg ug]{ 5}g .

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