1.A. Enrolled Year:*     1.B. Passed Year:*    

2. Program:*     -- Select Program -- A.N.M Lab Assistant C.M.A. Health Assistant (HA)

3. Full Name:*    

4. Gender: *     Male     Female    

5. Email: *    

6. Phone/Mobile.: *    

7. Present Address: *    

Current Status of the Student

8. What are you doing now in relation to your profession?: *

Self employment
Employment in: Governmental office
Employment in: Private office
Employment in: (I) NGO
Working in volunteer job
Further Study and Job
Further Study Only
Other

Information About Job

9. Name of office:*    

10. Designation in your Office:*    

11. Office Address:*    

12. Office Phone:*    

13. Office Email:   

14. Contact Person in office:*    

15. Your Responsibility in office:*    

16. Annual Salary:*    

Further Study Status (If any)

17. Which course are you studying now?:   

18. University:   

19. College:   

Personal Experience

20. Your Experience at your job?: *

Hard to handle
Easy to handle
Other

21. Does your theory and practical knowledge from HuRDRI guides you in job sufficiently?: *

Yes
Not Much
No


22. Are you satisfied with your profession?: *

Satisfied
Not Satisfied
Average
Can be good if got professionals assistance
I am not satisfied with my job
Other

Other

23. प्रस्तावित चिकित्सा शिक्षा ऐन नेपालमा TSLC तहका कार्यक्रमहरु (CMA, ANM, Lab Assistant) बन्द गर्ने प्रस्तावना छ। तपाइको बिचारमा यी कार्यक्रम बन्द हुनु उचित हो ? *

हो (Yes)
होइन (No)