CBHI form No. 04
Annually State / UT
 NUMBER OF STATE/UT GOVT. EMPLOYED *DOCTORS AND DENTAL SURGEONS
AS ON 31 DECEMBER OF THE REPORTING YEAR
       
NAME OF THE STATE/UT:   Reporting year ** December  
Sl.No. Doctors / Dental Surgeons STATE GOVT LOCAL GOVT BODIES TOTAL
Purely State Autonomous Purely local Bodies Autonomous NO. OF DOCTORS
    M F T M F T M F T M F T M F T
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
1 Allopathic Doctors
1.1 General duty                              
1.2 Specialists
1.2.1  General Surgeons                              
1.2.2 Obst. & Gyane.                              
1.2.3 Physicians                              
1.2.4  Pediatricians                              
1.2.5  Anaesthetists                              
1.2.6  Psychiatrists                              
1.2.7 Orthopedic Surgeons                              
1.2.8 Radio diagnostics                              
1.2.9 Onchologists                              
1.2.10 Others Specialist Doctors(Attach Statement)                              
2 AYUSH Doctors
2.1 Ayurveda                              
2.2 Unani                              
2.3 Siddha                              
2.4 Homoeopathy                              
2.5 Others Pathy Doctors(Attach Statement)                              
3 DENTAL SURGEON                              
  GRAND TOTAL(Allopathic Doctors+AYUSH Doctors+DENTAL SURGEON)                              
NOTE:  M - Male,    F - Female, T-Total
 All Doctors / Dental Surgeons employed in Clinical / Non-Clinical Govt.establishments including those involved in administrative duties.
* State/UT, Public Sector Undertakings, Municipalities, Municipal Corporation, Zilla Parishads, Village Panchayat, Autonomous Govt. bodies of State & Local Govts.
     etc. in various establishments like teaching institutions,hospitals, dispensaries, clinics, polyclinics, sanatoria,CHCs, PHCs etc
** - Duly completed proforma as on December should be sent to reach CBHI New Delhi by 25th January of the succeeding year through E-mail: dircbhi@nb.nic.in to enable CBHI for national compilation by February.
To The Director Signature  
Central Bureau of Health Intelligence (CBHI) Name & Designation  
401-A, Nirman Bhavan, New Delhi - 110011 Address with Tel/ Fax  
Tel/ Fax: 91-011-23063175 / 23062695 & E-Mail