Please fill out this employment information form. It will provide much needed data for our Human Resources Dept.
Position Applied for: Doctor in ER resident&Ob-gyn Date of Application: 15/10/2015
Personal Information
Full Name
Dr Zainab Mohamed Yaseen
Age-47
Nationality
Indian
Place of Birth
india
Gender
Female
Religion
Muslim
Saudi Commission license
ترخيص الهيئة السعودية وتاريخها
08-R-M-0216124
Passport No.
K5134503
Place of Issue
India.Renewal at Riyadh
Expiry Date
21/06/2023
Phone No. (Landline)
Mobile No.
Iqama ID/ Saudi ID
Place of Issue
hail-MOH
Expiry Date
27/3/1437
Marital Status
MARRIED
Work Experience: Please start with the most recent employment
Company Name
MINISTRY OF HEALTH
Phone No.
Job Title
ob&gynec resident
Monthly Salary (SAR)
14000 SR
From
18/11/1995} from the beginning}
To -Up to date
Reason for Leaving
I want more salary
Brief description of Job you performed
can manage ER cases&ob gynec cases.& also hemodialysis with ICU
Company Name
MINISTRY OF HEALTH
Phone No.
Job Title
ob&gynec resident
Monthly Salary (SAR)
14000SR
From
2512/1428-{SAUDI Experience}
To-up to date
Reason for Leaving
I want more salary
Brief description of last job you performed
Manage ER cases without support,ob-gynec cases&icu
Education:
Degree/Certificate
Major
Institution Name
Location
Date of Graduation
MBBS
Madurai Medical college
Madurai-Tamil nadu-India
1986
preventive medicine& OB-GYNEC
Govt.hospital-madurai.India
Madurai-India
1995
Training, Certification & Vocational Courses: List any other qualifications and/or specialized training/skills you possess
Training/Certification
Course Title
Name of Institute
Date
health&family medicine
family medicine
govt.hospital-india
2005
Emergency medicine&hemodialysis-AKU
Emergency medicine
King Khalid hospital-Hail-KSA
2009
Computer Applications: kindly indicate your proficiency in software programs
Name of Software/Application
Skill Level (Expert/Intermediate/Beginner)
Years of Experience
basic computer
Intermediate
5 yrs
Languages:
English
Read
good
Written
good
Spoken
good
Arabic
Read
good
Written
poor
Spoken
fair
Contact Details (Permanent Address)
Address Line 1
Shamly general hospital,shamly,Hail region,Kingdom of saudi arabia
Address Line 2
1749,TNHB,West Anuppanady,Madurai,Tamilnadu,India.625009.
Post Code
625009 {india}
P.O. Box- 15{saudi}
City
Shamly-Hail region
Country saudi arabia
Tel No.
Mobile No.+966*********
Address in KSA (Candidates residing in KSA)
Address Line 1
Shamly general hospital.shamly-Hail region,Saudi arabia
P.O. Box
15
City-Hail
Tel No.
Mobile No.+966*********
In the Event of an Emergency Please Notify:
1. Name
Reshma Parveen
Phone (Landline)
Relationship
daughter
Mobile #
Address
1749.TNHB.West Anuppanady,Madurai,Tamilnadu,India
2. Name
Sofia
Phone (Landline)
Relationship
daughter
Mobile #
Address
Sponsor Details (For Candidates residing in KSA):
Name of Sponsor
Ministry of health
Address of present sponsor
MOH
Tel No. present sponsor
General Information
Would you be able to start working immediately?
NO .I want to know the detail of your job&salary&THEN 6 month if ‘NO’ how soon can you start:
Are you legally eligible for employment in this country?
yes
Have you ever been convicted of a felony?
no
Do you have any health problem?
no If ‘Yes’ please explian:
Do you have private work?
no
Are you employed now?
yes
Can you drive a car?
yes
License No.
Brief description about your personality (I.E. self-motivation, doer or thinker, working under pressure, commitment and quality of work, team player etc.)
i am soft nature,faith in Allah so much.I respect team work.Hard&active worker.
By signing this form or sending it to Aya Specialist Medical Hospital by e-mail, the applicant declares that all the information provided is complete & accurate. Providing false information during any part of the employment process, and information on this application, can lead to rejecting the application, and can also lead to termination of employment after joining Aya Specialist Medical Hospital.
I confirm that I have no criminal record and all above information are correct and the Est. is free to do what is necessary if not, I affix my signature below.
Signature zainab mhamed Date 02/01/1437