Office of the Election Commissioner - AROI-WB Chapter
AROIWB Election 2025 - Nominations Submission
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Name :
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AROI LM Number :
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Year of Membership :
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Designation:
Select Designation
Assistant Professor
Associate Professor
Associate Consultant
Consultant
Junior Resident year 1 (JR1)
Junior Resident year 2 (JR2)
Junior Resident year 3 (JR3)
Medical Officer
Professor
RMO / Tutor
Senior Consultant
Senior Resident year 1 (SR1)
Senior Resident year 2 (SR 2)
Senior Resident year 3 (SR 3)
Other
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Other Designation :
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Institution :
Select Institution
ABVRCC, Agartala Govt Medical College
AMRI Hospital, Dhakuria, Kolkata
Apollo Multi-speciality Hospital, Kolkata
B.R.Singh Hospital, Kolkata
Bankura Sammilani Medical College & Hospital, Bankura
Bishnupur district hospital, Bishnupur
Burdwan Medical College and Hospital, Purba Bardhaman
Chinsurah District Hospital, Chinsurah
Chittaranjan National Cancer Institute, Kolkata
Ggs medical college, Faridkot
HCG EKO Cancer Centre
I.P.G.M.E.R & SSKM Hospital, Kolkata
Malda Medical College Malda
Medanta, The Medicity
Medella Cancer Cure Centre
Medica Cancer Hospital, Kolkata
Medica Cancer Hospital Rangapani
Medical College & Hospital, Kolkata
Midnapore Medical College, Midnapore
MR Bangur Hospital, Kolkata
Murshidabad Medical College
Nadia District Hospital
Narayana Superspeciality Hospital, Howrah
Netaji Subhas Chandra Bose Cancer Hospital, Kolkata
Nil Ratan Sircar Medical College and Hospital, Kolkata
North Bengal Medical College & Hospital
R G Kar Medical College & Hospital, Kolkata
Ruby Cancer Center, Kolkata
Saroj Gupta Cancer Centre & Research Institute, Thakurpukur, Kolkata
Tata main Hospital, Jamshedpur
Tata Medical Center, Kolkata
Other
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Other Institution :
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Post Applied for :
Select Post Applied for
President
Vice President
Secretary
Joint Secretary
Treasurer
Assistant Treasurer
Member Executive Committee
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Previously part of the Executive Committee Yes / No :
Yes
No
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Highest Post Held :
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Duration of Highest Post held in Years :
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Name of Proposer :
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AROI LM Number of Proposer :
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Name of Seconder :
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AROI LM Number of Seconder :
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Email:
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Mobile (Preferably with WhatsApp facility):
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1. I have read the Notice number 2 regarding eligibility for the post applied thoroughly and comply to the same.
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2. I am currently residing in West Bengal, India.
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3. I am an eligible voter as per the Voters' List for the AROI WB Chapter Elections 2025 and my name is included in the same.
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4. I am submitting my CV along with by mail to aroiwb@gmail.com.
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5. I am submitting the requisite fees by ONLINE transfer to
AROI WB bank account as
mentioned in Notice number 2.
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6. Both the Proposer and Seconder, whose names are mentioned above are mailing their mails in support of my nomination to aroiwb@gmail.com.
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7. I am aware that all information furnished by me above are correct and any discrepancies found during scrutiny by the Election Commission may subject my nomination to be considered disqualified.
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Captha :