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Note:The Undertaking is to be submitted at the time of joining the Medical College to the
Dean of respective Government Medical College to which the candidate has been admitted in
the academic year 20 -20 as per Government of Gujarat Heath and Family Welfare
Department Gandhinagar Resolution NO.MCG/1019/1643/J, dated .....................
(Make it on Rupees 300 /-stamp paper)
UNDERTAKING
Name of Student:
- - - - - - - - - - - - - -·Admission Year: 20 -20
(ii) After passing the said examination, the student shall within a period of 30
days, inform to the Commissioner of Health, Medical Services, Medical
Education and Research(hereinafter referred to as COH) to offer himself for
the Government/Rural Services and if the student is called upon by the
Government or COH, the student shall serve the Government / District
Panchayat I Local Authority for one year in such grade and remuneration as
may be prescribed by Government.
(iii) During the period of rural services, the student shallbe required to serve
under the provision of the bond, discharge the duties faithfully assigned to
him/her and observe the rules for the time being in force regulating the
conduct. The student cannot remain absent without prior permission of
competent authority.
(b) If the student before or after entering Government service, becomes ineligible for
appointment or continuation in Government service by his own misbehavior,
indiscipline or irregularity, he I she shall render himself/herself liable to pay to
Government in addition to the said bond amount penalty for breach of agreement as
may be decided by the concerned Government officer and such amount will be
recovered from the student I Guardian /either of sureties as the absolute discretion of
the Government.
(c) It shall not be necessary for the Government to inform any of the students before
suing the guardian or either of the sureties for recovering the amount due hereunder.
(d) The liability of the sureties hereunder or either of them shall not be discharged by
any reason . .
(e) Where the student is desirous of undergoing further studies and if he/ she secures
admission to course of further study in the same year, the bond of the student shall be
extended for the duration of the study and student shall be subject to the condition that
specific "No Objection Certificate", for pursuing the further studies is produced from the
Dean of the said college. Provided, however that if the stude".lt fails or neglects to pass
the course of further study examination within five years or abandons the further
studies prior thereto for any reason whatsoever, the conditions of the undertaking shall
be applicable to said student immediately. The Dean of the institute of such post
graduate student will inform Additional Director Medical Education about all such
candidates on 1st Jan and 30th June of each academic year.
Sureties
1. Name and Address Signature
Witness
1. Name and Address Signature
NOTARY
(Note :- Only attested Xerox copy of Aadhaar Card & Electricity Bill in the name of
Sureties & Witness should be attached with Bond Affidavit)
,.
Note:The duly executed Bond and Solvency Certificate are to be submitted at the time of
joining the Government Medical College to the Dean of respective college to which the
candidate has been admitted in the academic year 20 - 20 as per Government of Gujarat,
Health and Family Welfare Department, Resolution NO.MCG/1019/1643/J, dated ...... .......................... ..
WHEREAS, the Government has decided to prescribe a condition for admission to Government
Medical College for the Post Graduate Diploma or Degree course {hereinafter referred to 11 Said course")
that every student so admitted shall complete the said course from that college or from any other
Government Medical College in the state and that on such completion he or she shall if so required by
the Government serve in any of the rural areas of the state for a minimum period of 1 Year in the state
on such remuneration as my be prescribed other of and shall furnish a suitable bond for the due
performance of the said conditions .
AND WHEREAS, the student who had applied for admission for the said course in _ _ _ __
Medical College (hereinafter referred to as 11the said college.)NOW the condition of above written
obligation is that if the student shall:
{1) Fail to complete the Post Graduate Diploma or Degree course as here in above provided that
candidate shall pay to the Government on demand the amount of penalty of Bond as prescribed here
under.
{2) Diligently prosecute and comp lete the said course at the said college or any other Government
Medical College in the state and pass the prescribed university examination for the said course and
Within a period of 30 {Thirty) days from the date of passing final examination give to the Government by
REGISTRED POST NOTICE in writing provided however that if the student is desirous of continuing
further studies it shall be open to the Government in its absolute discretion to refuse such permission or
to grant it subject to condition that the student shall within one month from the completion of further
studies, give a like notice to the Government.
(3) When called upon by the Government shall at any time within a period of six months from the
receipt of the notice from the student as aforesaid join the State Service and serve in any of the rural
areas of the state for minimum period of one year in the state at such remuneration as may be
prescribed thereof and in the event of the student not being so called upon by the Government to join
the state services and serve them for the aggregate period of one year in any of the Rural Areas of the
state and during the period which the student is required to serve under provisions of this bond
faithfully discharge the duties assigned to him/her by the Government or his/her other superiors with
utmost diligence and efficiency and shall observe the rules for time being in force regulating the conduct
of persons so serving.
Then the above written bond shall become void otherwise the said shall remain in full force and
virtue.
And in the event of student committing a breach of any the above terms and conditions the
whole amount of Rs.40,00,000/- (Rupees Forty Lakhs only) (i.e. Solvency Certificate or Bank Guarantee
of Rs. 10.00 Lakhs and Undertaking of Rs. 30.00 Lakhs) as per Government of Gujarat, Health and
Family Welfare Department, ResolutionNO.MCG/1019/1643/J,dated ............................. or such lesser
sum as the Government may in its absolute discretions decide shall become payable jointly, or severally
by the student or the father/natural guardian of the student and the above surety
_ _ _ _ _ _ _ _ _ _ _ _ (full name of the surety) forthwith and the
Government may without prejudice any other right and remedies of the Government recover the same
from the student or the father or natural guardian of the student and the above surety.
And upon making of such payment the above written obligation shall be void and of no effect otherwise
it shall be and remain in full force and virtue;
Provided always and it is hereby agreed and declared that the decision of the Government at
whether the said student has or has not performed and observed any of the obligations. and conditions
herein before recited and the amount of the compensation payable in this behalf shall be final and
binding on the parties hereto.
Provided further that the liability of the surety here under shall not be impaired or discharged
by reasons of timebeing granted or any forbearance, act of omission of the Government (With or
without knowledge or consent of surety) in respect of or in relation of several obligations and
conditions to be performed or discharged by the student provided that the Government may without
prejudice to any other rights or remedies of the Government recovery such amount due here under
from student or from the father or natural guardian of the student or from surety as an arrears of land
revenue and provided further that this bond shall in all respect be governed by the laws of India.
I witness whereof the said student or father or natural guardian of the student in case he is a
minor and the said surety have put their respective hands day and the year herein above written
in presence of-
1. Signature:
Full Name:
2. Signature :
Full Name:
1. Signature:
Full Name:
2. Signature:
Full Name:
This is to certify_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
A candidate seeking admission to the Post Graduate Diploma or Degree Course is solvent to the
extent of the amount stipulated in Bond by the student or father or natural guardian of the
student in respect of above mentioned admission.
This certificate is issued on the strength of the attached solvency certified Dated
_ _ _ _ _ _ _ _ _ (in the form No.R.S.B 2g produced by the said surety.)
Seal Designation:
FORM NO.R.S.B 2g
Property's Market Value should be more than Rs.10,00,000/-(Rupees Ten Lakhs only)
1. Name
2.Father's Name
3. Residence
4.Age
5. Occupation
6. Purpose for which required
7. Whether the person certified possesses movable or immovable property or both:
8. If movable estimated value and grounds for belief:
9. If immovable
A. If in lands
B. If in house:
a. Where situated
b. Market Value
c. Whether it is in the sole ownership of the person certified and whether they have any
objections to urge.
d. Whether it is a join Hindu Family and if so the extent of his share, the names of other
coparceners and whether they have objection to urge.
Date: Signature
10. Report of the village officers of the place where the property is situated.
11. Opinion of the certifying officer.
Camp: Signature
Date:
N.B:- Asregard Nos. 8, 9 and 10, if the particulars required cannot be conveniently entered
against them they should be appended on separate sheets and the signature of the certifying
office and note to that effect against the number of item concerned.
Name _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _~
Father's Name
-------------------------
Res icid enc e
~--------------------------
Age. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Occupation _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Certifying Officer.