Upload
ngokiet
View
220
Download
3
Embed Size (px)
Citation preview
AWARD SCHEME
of
CCRUM
1. AYUSH Award Scheme-I : Best Research Paper Award
2. AYUSH Award Scheme-II : Young Scientist Award
3. AYUSH Award Scheme-III : Life Time Achievement Award
4. AYUSH Award Scheme-IV : Best Teacher Award
5. Application Proforma for nomination of Awards
Page 2 of 19
CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE
Jawahar Lal Nehru BharatiyaChikitsa Evam Homoeopathy Anusandhan Bhawan
No. 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-110058
AYUSH AWARD SCHEME-I: BEST RESEARCH PAPER AWARD
1. Background:
The Central Council for Research in Unani Medicine (CCRUM) is an autonomous
body of the Ministry of AYUSH (Unani, Yoga & Naturopathy, Unani, Siddha and
Homoeopathy), Government of India. It is an apex body in India for the formulation,
co-ordination, development and promotion of research on scientific lines in Unani
systems of medicine. The Council has been executing its research programmes with a
network of 23 peripheral Institutes/centres/units across the country with the
headquarters office responsible for control, monitoring and supervision. The broad
areas of Research comprise Pharmacological Research (Pre-clinical Safety/Toxicity
and Biological Activity Studies); Clinical Research; Literary Research; Drug
standardization Research and Survey, Cultivation of Medicinal Plants. The extension
activities include Tribal Health Care Research, Mobile Health Care Services, School
Health care services and Information, Education and Communication (IEC) etc. The
Central Council for Research in Unani Medicine (CCRUM) will invite nominations for
the Best Research Paper Award every year. The award will be given each year for
outstanding research contributions made primarily in the field of Unani in clinical,
literary and drug research separately.
2. Eligibility:
i. The award is to be given to the Scientists and researchers working in any
institution in the country and abroad for original and outstanding research
contributions made primarily in the field of Unani in clinical, literary and drug
research separately. The nominations may be supported by the original research
work done for the greater good of the humanity with contribution to the Unani field
in clinical, literary and drug research separately.
ii. The original research work submitted by the nominee should not have been
presented for any similar award elsewhere.
Page 3 of 19
iii. In case of a joint research work, the applicant for award shall furnish a No
Objection Certificate from other contributors for application. If NOC is not available
then the affidavit may be submitted by the applicant indicating the same.
iv. The original research work should only be of during last three calendar years from
the year of award.
v. The nominee should be referred by at least 3 authorities including Head of any
Unani research organization/ Unani PG Institution/ Director Unani/AYUSH of
State/Central Government/ UT Administration
vi. The Nominee should not be related either by blood, marriage or adoption to the
person making the nomination provided that such a person has not played any
direct part in the nominee’s work.
3. Incentives:
i. The Award comprises a certificate, a cash award of Rs 50,000 (Rupees Fifty
thousand only) and a memento or plaque.
ii. The award certificate shall indicate the title of research paper along with all names
of contributors, if any, in the same sequence as given in the paper.
4. How to Apply:
Nominations addressed to Director General, Central Council for Research in Unani
Medicine (CCRUM), 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-
110058 should be sent as per the prescribed proforma (original + five copies) latest by
15th December 2017. A CD/DVD/USB flash drive is also required containing digital
photograph (in JPEG format), duly filled proforma and significant publications (in PDF
format) of the nominee. The details of the Best Research Paper Award and the
prescribed proforma for nomination may be obtained from above address or may also
be downloaded from website: www.ccrum.res.in.The application should be sent in an
envelope super scribed “Application/ Nomination for Best Research Paper Award” by
registered / speed post. In case of nominee from abroad, the form should be
forwarded through Ministry of AYUSH, Government of India fulfilling all the
requirements as per guidelines for foreign nominations.
5. Procedure of Selection and Award:
i) The Prize is bestowed on a scientist and researcher working in any institution in
the country and abroad, who has made conspicuously important and
Page 4 of 19
outstanding contributions to human knowledge and progress – fundamental and
applied – in the particular field of endeavour, which is his/her specialization.
ii) In case of a joint research work, the applicant for award shall furnish a No
Objection Certificate from other contributors for application or an affidavit
indicating the same.
iii) The Prize is awarded on the basis of contributions made through work done
during last three calendar years from the year of award.
iv) An Expert Committee with the following composition will examine the proposal
and take the decision for Award:
1. Chairman - An renowned Unani expert
2. Member - Representative from Min. of AYUSH not
lower than Advisor
3. Subject Expert - Three (as nominated by Member Secretary)
4. Member Secretary - DG, CCRUM
v) The names of the recipients are made public on National Unani Day by the
Director General, CCRUM.
vi) The Prizes are awarded at a formal presentation ceremony arranged by
CCRUM. At the ceremony, a suitable citation on work of the recipient of the
Prize is read out.
vii) The Best Research Paper Awardee should present his /her work in CCRUM
Hqrs. or a venue as will be intimated for the purpose of dissemination of
research work.
viii) In all matters of award, the decision of CCRUM shall be final.
Terms of Reference for Expert Committee:
1. The Committee will appraise the proposals and after critical examination will
recommend the suitable proposal for award.
2. The Committee will decide and recommend award based on essential
parameters such as: novelty, scientific relevance, methodology, translational
potential, contemporary relevance etc.
3. The Committee will finalize and recommend through a consultative process.
4. The Committee may or may not recommend for award, if no any suitable
proposal is found up to the mark in all or any of the fields.
Page 5 of 19
CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE
Jawahar Lal Nehru BharatiyaChikitsa Evam Homoeopathy Anusandhan Bhawan
No. 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-110058
AYUSH AWARD SCHEME-II: YOUNG SCIENTIST AWARD
1. Background:
The Central Council for Research in Unani Medicine (CCRUM) is an autonomous
body of the Ministry of AYUSH (Unani, Yoga & Naturopathy, Unani, Siddha and
Homoeopathy), Government of India. It is an apex body in India for the formulation,
co-ordination, development and promotion of research on scientific lines in Unani
systems of medicine. The Council has been executing its research programmes with a
network of 23 peripheral Institutes/centres/units across the country with the
headquarters office responsible for control, monitoring and supervision. The broad
areas of Research comprise Pharmacological Research (Pre-clinical Safety/Toxicity
and Biological Activity Studies); Clinical Research; Literary Research; Drug
standardization Research and Survey, Cultivation of Medicinal Plants. The extension
activities include Tribal Health Care Research, Mobile Health Care Services, School
Health care services and Information, Education and Communication (IEC) etc. The
Central Council for Research in Unani Medicine (CCRUM) will invite nominations for
the Young Scientist Award every year in clinical, literary and drug research separately.
2. Eligibility:
i. The award is to be given to scientists and researchers working in any institution in
the country and abroad for original and outstanding research contribution(s) made
primarily in the field of Unani in clinical, literary, and drug research separately.
ii. The nominations may be supported by the original research work done for the
greater good of the humanity with contribution to the Unani field.
iii. The original research work submitted by the nominee should not have been
presented for any similar award elsewhere.
iv. The age limit for the award shall be up to 45 years on or before 31st July 2017.
v. A certificate shall be furnished from the organisation where the applicant scientist
works regarding his employment. The nominee should be referred by at least 3
Page 6 of 19
authorities including Head of any Unani research organization/ Unani PG
Institution/ Director Unani/AYUSH of State/Central Government/ UT Administration
vi. The Nominee should not be related either by blood, marriage or adoption to the
person making the nomination provided that such a person has not played any
direct part in the nominee’s work.
3. Incentives:
The Award comprises a certificate, a cash award of Rs 1,00,000 (Rupees One lakh
only) and a memento or plaque.
4. How to Apply:
Nominations addressed to Director General, Central Council for Research in Unani
Medicine (CCRUM), 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-
110058 should be sent as per the prescribed proforma (original + five copies) latest by
15th December 2017. A CD/DVD/USB flash drive is also required containing digital
photograph (in JPEG format), duly filled proforma and significant publications (in PDF
format) of the nominee. The details of the Young Scientist Award and the prescribed
proforma for nomination may be obtained from above address or may also be
downloaded from website: www.ccrum.res.in. The application should be sent in an
envelope super scribed “Application/ Nomination for Young Scientist Award” by
registered / speed post. In case of nominee from abroad, the form should be
forwarded through Ministry of AYUSH. Government of India fulfilling all the
requirements as per guidelines for foreign nominations.
5. Procedure of Selection and Award:
i) The Prize is bestowed on a scientist and researcher working in any institution in
the country and abroad who has made conspicuously important and
outstanding contributions to human knowledge and progress – fundamental and
applied – in the particular field of endeavour, which is his/her specialization.
ii) The Prize is awarded on the basis of contributions made through work done
during the preceding years of the Prize.
iii) An Expert Committee with the following composition will examine the proposal
and take the decision for Award:
1. Chairman - A renowned Unani expert
Page 7 of 19
2. Member - Representative from Min. of AYUSH not
lower than Advisor
3. Subject Expert - Three (as nominated by Member Secretary)
4. Member Secretary - DG, CCRUM
iv) The names of the recipients are made public on National Unani Day by the
Director General, CCRUM.
v) The Prizes are awarded at a formal presentation ceremony arranged by
CCRUM. At the ceremony, a suitable citation on work of the recipient of the
Prize is read out.
vi) The Young Scientist Awardee should present his /her work in CCRUM Hqrs. or
a venue as will be intimated for the purpose of dissemination of research work.
vii) In all matters of award, the decision of CCRUM shall be final
Terms of Reference for Expert Committee:
1. The Committee will appraise the proposals and after critical examination will
recommend the suitable proposal for award.
2. The Committee will decide and recommend award based on essential
parameters such as: novelty, scientific relevance, methodology, translational
potential, contemporary relevance etc.
3. The Committee will finalize and recommend through a consultative process.
4. The Committee may or may not recommend for award, if no any suitable
proposal is found up to the mark in all or any of the fields.
Page 8 of 19
CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE
Jawahar Lal Nehru BharatiyaChikitsa Evam Homoeopathy Anusandhan Bhawan
No. 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-110058
AYUSH AWARD SCHEME-III. LIFE TIME ACHIEVEMENT AWARD
1. Background:
The Central Council for Research in Unani Medicine (CCRUM) is an autonomous
body of the Ministry of AYUSH (Unani, Yoga & Naturopathy, Unani, Siddha and
Homoeopathy), Government of India. It is an apex body in India for the formulation,
co-ordination, development and promotion of research on scientific lines in Unani
systems of medicine. The Council has been executing its research programmes with a
network of 23 peripheral Institutes/centres/units across the country with the
headquarters office responsible for control, monitoring and supervision. The broad
areas of Research comprise Pharmacological Research (Pre-clinical Safety/Toxicity
and Biological Activity Studies); Clinical Research; Literary Research; Drug
standardization Research and Survey, Cultivation of Medicinal Plants. The extension
activities include Tribal Health Care Research, Mobile Health Care Services, School
Health care services and Information, Education and Communication (IEC) etc. The
Central Council for Research in Unani Medicine (CCRUM) will invite nominations for
the Life Time Achievement Award every year for the best practitioner, best researcher
and best academician, separately.
2. Eligibility:
i. The purpose of the award is to give recognition to individuals whose life time work
has contributed significantly for enhancing Unani knowledge and practices. The
award is to be given to the best practitioner, best researcher and best academician
separately in the field of Unani for contributing a great deal of service to the nation
in different spheres of activities in Unani.
ii. The nominations may be supported by a bio data along with statement of work,
achievement, accomplishment or performance on which the claim to the award is
based.
iii. Details of publications, if any.
Page 9 of 19
iv. The nominee should be referred by at least 3 authorities including Head of any
Unani research organization/ Unani PG Institution/ Director Unani/ AYUSH of
State/Central Government/ UT Administration
v. The Nominee should not be related either by blood, marriage or adoption to the
person making the nomination provided that such a person has not played any
direct part in the nominee’s work.
3. Incentives:
The Award comprises a certificate, a cash award of Rs 2,00,000 (Rupees Two lakh
only) and a memento/plaque.
4. How to Apply:
Nominations addressed to Director General, Central Council for Research in Unani
Medicine (CCRUM), 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-
110058 should be sent as per the prescribed proforma (original + five copies) latest by
15th December 2017. A CD/DVD/USB flash drive is also required containing digital
photograph (in JPEG format), duly filled proforma and significant publications (in PDF
format) of the nominee. The details of the Life Time Achievement Award and the
prescribed proforma for nomination may be obtained from above address or may also
be downloaded from website: www.ccrum.res.in. The application should be sent in an
envelope super scribed “Application/ Nomination for Life Time Achievement Award” by
registered / speed post.In case of nominee from abroad, the form should be forwarded
through Ministry of AYUSH, Government of India fulfilling all the requirements as per
guidelines for foreign nominations.
5. Procedure of Selection and Award:
i) The Prize is bestowed on a person who has made conspicuously important and
outstanding contributions to human knowledge and progress – fundamental and
applied – in the particular field of endeavour, which is his/her specialization.
ii) The Prize is awarded on the basis of contributions made through work done during
the preceding years of the Prize.
Page 10 of 19
iii) An Expert Committee with the following composition will examine the proposal and
take the decision for Award:
1. Chairman - An renowned Unani expert
2. Member - Representative from Min. of AYUSH not
lower than Advisor
3. Subject Expert - Three (as nominated by Member Secretary)
4. Member Secretary - DG, CCRUM
iv) The names of the recipients are made public on National Unani Day by the
Director General, CCRUM.
v) The Prizes are awarded at a formal presentation ceremony arranged by CCRUM.
At the ceremony, a suitable citation on work of the recipient of the Prize is read out.
vi) The Life Time Achievement Awardee should present his /her work in CCRUM
Hqrs. or a venue as will be intimated for the purpose of dissemination of research
work.
vii) In all matters of award, the decision of CCRUM shall be final.
Terms of Reference for Expert Committee:
1. The Committee will appraise the proposals and after critical examination will
recommend the suitable proposal for award.
2. The Committee will decide and recommend award based on essential
parameters such as: novelty, scientific relevance, methodology, translational
potential, contemporary relevance etc.
3. The Committee will finalize and recommend through a consultative process.
4. The Committee may or may not recommend for award, if no any suitable
proposal is found up to the mark in all or any of the fields.
Page 11 of 19
CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE
Jawahar Lal Nehru BharatiyaChikitsa Evam Homoeopathy Anusandhan Bhawan
No. 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-110058
CCRUM AWARD SCHEME IV. BEST TEACHER AWARD
1. Background:
The Central Council for Research in Unani Medicine (CCRUM) is an autonomous
body of the Ministry of AYUSH (Unani, Yoga & Naturopathy, Unani, Siddha and
Homoeopathy), Government of India. It is an apex body in India for the formulation,
co-ordination, development and promotion of research on scientific lines in Unani
systems of medicine. The Council has been executing its research programmes with a
network of 23 peripheral Institutes/centres/units across the country with the
headquarters office responsible for control, monitoring and supervision. The broad
areas of Research comprise Pharmacological Research (Pre-clinical Safety/Toxicity
and Biological Activity Studies); Clinical Research; Literary Research; Drug
standardization Research and Survey, Cultivation of Medicinal Plants. The extension
activities include Tribal Health Care Research, Mobile Health Care Services, School
Health care services and Information, Education and Communication (IEC) etc. The
Central Council for Research in Unani Medicine (CCRUM) will invite nominations for
the Best Teacher Award every year in the field of pre-clinical, clinical, literary, and drug
research.
2. Eligibility:
i. The purpose of the award is to give recognition to the eminent teachers who have
contributed significantly for enhancing Unani knowledge and practices. The award
is to be given to the best teacher in the field of Unani for contributing a great deal
of service to the nation in different spheres of activities in Unani.
ii. The nominations may be supported by a bio data along with statement of work,
achievement, accomplishment or performance on which the claim to the award is
based.
iii. Details of publications.
Page 12 of 19
iv. The nominee should be referred by at least 3 authorities including Head of any
Unani research organization/ Unani PG Institution/ Director Unani/AYUSH of
State/Central Government/ UT Administration.
v. The Nominee should not be related either by blood, marriage or adoption to the
person making the nomination provided that such a person has not played any
direct part in the nominee’s work.
3. Incentives:
The Award comprises a certificate, a cash award of Rs 2,00,000 (Rupees Two lakh
only) and a memento/plaque.
4. How to Apply:
Nominations addressed to Director General, Central Council for Research in Unani
Medicine (CCRUM), 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-
110058 should be sent as per the prescribed proforma (original + five copies) latest by
15th December 2017. A CD/DVD/USB flash drive is also required containing digital
photograph (in JPEG format), duly filled proforma and significant publications (in PDF
format) of the nominee. The details of the Best Teacher Award and the prescribed
proforma for nomination may be obtained from above address or may also be
downloaded from website: www.ccrum.res.in. The application should be sent in an
envelope super scribed “Application/ Nomination for Best Teacher Award” by
registered / speed post. In case of nominee from abroad, the form should be
forwarded through Ministry of AYUSH. Government of India fulfilling all the
requirements as per guidelines for foreign nominations.In case of nominee from
abroad, the form should be forwarded through Ministry of AYUSH, Government of
India fulfilling all the requirements as per guidelines for foreign nominations.
5. Procedure of Selection and Award:
i) The Prize is bestowed on a teacher of Unani in the country or abroad, has made
conspicuously important and outstanding contributions to human knowledge and
progress – fundamental and applied – in the particular field of endeavour, which is
his/her specialization.
ii) The Prize is awarded on the basis of contributions made through work done during
the preceding years of the Prize.
Page 13 of 19
viii) An Expert Committee with the following composition will examine the proposal and
take the decision for Award:
1. Chairman - An renowned Unani expert
2. Member - Representative from Min. of AYUSH not
lower than Advisor
3. Subject Expert - Three (as nominated by Member Secretary)
4. Member Secretary - DG, CCRUM
ix) The names of the recipients are made public on National Unani Day by the Director
General, CCRUM.
iii) The Prizes are awarded at a formal presentation ceremony arranged by CCRUM.
At the ceremony, a suitable citation on work of the recipient of the Prize is read out.
iv) The Best Teacher Awardee should give a speech to share his work & experiences
in CCRUM Hqrs. or a venue as will be intimated for dissemination of research
work.
v) In all matters of award, the decision of CCRUM shall be final.
Terms of Reference for Expert Committee:
1. The Committee will appraise the proposals and after critical examination will
recommend the suitable proposal for award.
2. The Committee will decide and recommend award based on essential
parameters such as: novelty, scientific relevance, methodology, translational
potential, contemporary relevance etc.
3. The Committee will finalize and recommend through a consultative process.
4. The Committee may or may not recommend for award, if no any suitable
proposal is found up to the mark in all or any of the fields.
Page 14 of 19
CENTRAL COUNCIL FOR RESEARCH IN UNANI MEDICINE Jawahar Lal Nehru Bharatiya Chikitsa Evam Homoeopathy Anusandhan Bhawan
No. 61-65, Institutional Area, Opp. ‘D’ Block, Janakpuri, New Delhi-110058
NOMINATION PROFORMA FOR THE YEAR ____2017____________
Original + 5 copies must be forwarded latest by 15th December, 2017. Digital photograph (preferably in
JPEG), softcopy of duly filled proforma (preferably in MS-WORD) and soft/ scanned copy of significant
publications (preferably in PDF) of the nominee on a single CD/DVD are also required.
1. Name of the Nominee in Full :
(Both in English and Hindi - for Indian nominee)
Dr
2. (a) Date and place of birth : (Enclose certificate of the age duly attested)
(b) Nationality: (c) Gender: M/F
(d) Age as on 1st January of the year of application:
_____Year(s)_______Month(s)______Day(s)
3. Address with Telephone /Mobile/Fax /e-mail:
(a) Official: (b) Residential Address:
(Present designation, department, institute etc.)
4. Discipline under which to be considered (only one to be marked √):
(Fill one form for one award only)
AWARD FIELD
(i) Best Research Paper Award : Literary Clinical Drug
(ii) Young Scientist Award : Literary Clinical Drug
(iii) Life Time Achievement Award : Practitioner Researcher Academician
(iv) Best Teacher Award : Literary Clinical Drug
5. Nominee's field of specialization/ Super-specialization:
Coloured
Passport size
Recent
Photograph of
Nominee
Page 15 of 19
6. Academic Qualifications (Please enclose a copy of each degree/certificate & mark-sheet):
Examination Name of the
examination/
degree/diploma
Name of University/
Board
Percentage of
marks Obtained
(%)
Division obtained
Year of passing
Subject(s) (Major) /
Specialization
Distinction , if any/
Additional
Particulars
(i) 10+2 or
equivalent
(ii) Bachelor degree
(iii) Master Degree
(iv) Doctorate degree
(v) Any
other
examination(s)
7. Details of any Scholarship /Fellowship/ Associateship/ Awards held, if any or from other
sources/ agencies.
(Indicate dates of joining & leaving):
(a) Scholarships / Fellowships/Associateship received with details:
__________________________________________________________________________
__________________________________________________________________________
(b) Honours/Medals/Awards, etc. with details: ___________________________________________________________________________
8. Working Experience (Starting from the present position): Office/Institute/ Post held From To Scale of Pay & Nature of Actual
Organisation Basic Pay Duties Duration
(Years &
Months)
Page 16 of 19
Total experience a. Teaching: Years________________ Months_______________ b. Research: Years_______________ Months_______________
c. Research Guide/ Supervisor: Years________________ Months_______________
d. Other: Years________________ Months_______________ (Specify)
9. Research: a) Research Projects:
S. Title of Project (s) Period ( From Budget Funding PI or Co-PI Status of
No. -To) / No. of agency (Status) Project
years completed
/ongoing
b) Patent/ Innovation/Technology developed/commercialized:_______________________
_________________________________________________________________________
_________________________________________________________________________
c) No. of candidates (MD/MS/Ph.D) Supervised:___________________________________
10. (a) Significant foreign assignments:
S. No.
Period of visit
Institute/ country visited Purpose of visit
From To
Page 17 of 19
(b) Total time spent abroad: _______Year______ Month______ Day
11. Scientific publications (published or accepted):
(One set of reprints to be enclosed. Softcopy of reprints preferably in PDF are also required)
(a) Research papers and Reviews (published in peer review & indexed journals only) *
S. No.
Authors Title Journal with year, volume & page no.
Index (ISSN) Impact factor of Journal
Citation
(b) Books/Manual/Monograph/ Research Bulletins/Extension Bulletins/ Chapters
in Scientific Books, Training/Teaching Manuals*
S.
No. Authors/
Co- author Title Publisher/Journal with page
number Year
*Enclose separate sheet in the prescribed format (if required)
12. Conference/workshop- Total Attended:
a. National: ________________________
b. International: (i) In the country:____________ (ii) Abroad:__________
13. Paper presented:
a. National: ________________________
b. International: (i) In the Country:_____________ (ii) Abroad:__________
14. Extra-curricular activities e.g. Games, sports, NCC, NSS, Community health service/ activities
etc.: ________________________________________________________________________
Page 18 of 19
__________________________________________________________________________
__________________________________________________________________________
15. Membership/Fellowship of Scientific Societies/Bodies, if any (Give details): __________________________________________________________________________
__________________________________________________________________________
16. (a) Significant Academic/Research contributions to science and/ or technology development by
the nominee based on the work done (in about 500 words).
(b) Summarise the most significant work of the nominee on which the recommendation is
based (in 50 words):
(c) Impact of the contributions in the field concerned, basic or applied:
17. Have the achievements already been recognized by Awards by any learned body. If so, the
name of the body, award and the year of award may be given. (A copy of the citation should be
enclosed):
18. Has the nominee delivered invited lecture(s) in India / abroad and/ or chaired any scientific
National/ International Conference Symposium (give details):
19. Names, correspondence address (with contact No. & email IDs) and broad area of
specialization of 3 Distinguished Scientists/ Authorities of Unani (As possible referees):
Sl. No.
Name Complete Address (with designation &
department)
Specialization Contact No. and E-
mail Id
(1)
(2)
(3)
20. Additional information of relevance, if any which you would like to mention:
__________________________________________________________________________
__________________________________________________________________________
_________________________________________________________________________
Page 19 of 19
(Enclose separate sheet, if the space is insufficient in any column)
Certified that information given in the above proforma is correct.
Place Sponsor’s Signature
Date Sponsor’s Name, Designation and
complete address with email address
NOTE:
• The prescribed pro-forma (Original + 5 copies) should be neatly typewritten giving complete
information about the nominee should be sent to:
Director General
Central Council for Research in Unani Medicine
Jawahar Lal Nehru Bharatiya Chikitsa Evam Homoeopathy Anusandhan Bhawan
No. 61-65, Institutional Area, Opp. ‘D’ Block
Janakpuri, New Delhi-110058
• In case of nominee from abroad, the form should be forwarded through Ministry of
AYUSH, Government of India fulfilling all the requirements as per guidelines for foreign
nomination.
• Please strictly follow prescribed format for filling up nomination proforma. Incomplete
nomination proforma will not be considered.
• Only one Proforma is to be filled up for each award separately.
• No field is to be left blank. Strike out the fields not applicable.
• Digital photograph (preferably in JPEG), softcopy of duly filled proforma (preferably in MS-
WORD) and soft copy of the reprints (preferably in PDF) of the nominee on single CD/DVD
are also required.
• Please mention current correspondence address, email IDs and broad area of specialization of
the 3 Distinguished Scientists as possible referees under Serial no 18.
• Each copy of the pro-forma should be properly tagged.
• Please do not attach any testimonial in original (attach only attested photocopies).
• Enclose attested copy of certificate of age
CHECK LIST
❖ Dully filled proforma (Original + 5 copies)
❖ A CD/ DVD /Pen-drive containing
I. Digital photograph (preferably in JPEG format)
II. Softcopy of duly filled proforma (preferably in MS-WORD format)
III. Soft copy of publications/reprints (preferably in PDF format)
❖ Attested copy of certificate of Age, academic qualification, experience, services etc.
LAST DATE for receipt of nominations: 15th December, 2017