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    Clinical PA 2024

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    sleeplabpulmo

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Clinical PA 2024

    Uploaded by

    sleeplabpulmo
    5 views3 pages

    Original Title

    Clinical PA 2024

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    5 views3 pages

    Clinical PA 2024

    Uploaded by

    sleeplabpulmo

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    MTI-KHYBER TEACHING HOSPITAL

    (Medical Teaching Institution)


    HUMAN RESOURCE
    Performance Evaluation Form Clinical (Doctors,
    Nursing, Paramedics)
    ISSUE #: 02 DOCUMENT #: HRD-F-24 Formulation DATE: 13-11-2023

    TO BE FILLED BY EMPLOYEE

    Employee Name: Gender: M F


    MR No. DOJ Period of Assessment:
    Designation: Department:

    TO BE FILLED BY SUPERVISOR
    RATING CRITERIA
    Minimum Maximum
    Rating Grade
    Score Score
    Outstanding (O-S) 86 100
    Exceeds Expectations (E-E) 71 85
    Meets Expectations (M-E) 56 70
    Improvement Needed (I-N) 41 55
    Unacceptable (U-A) 0 40
    TO BE FILLED BY SUPERVISOR

    RATING CRITERIA
    Score
    S. No. Work Essentials(Please ✓the appropriate box) 5 4 3 2 1 Total Score
    (O-S) (E-E) (M-E) (I-N) (U-A)
    1 Adherence to Duties in Job Description.

    2 Appearance, Conduct & Discipline.

    3 Communication Skills. (verbal/written)

    4 Managing Change and Improvement.

    5 Work Efficiency & Quality.

    Planning, Decision Making & Problem Solving


    6
    Ability.
    7 Performance under stress.

    8 Punctuality.

    9 Professional behavior.

    10 Relation with Colleagues & Visitors.

    Page 1 of 3
    MTI-KHYBER TEACHING HOSPITAL
    (Medical Teaching Institution)
    HUMAN RESOURCE
    Performance Evaluation Form Clinical (Doctors,
    Nursing, Paramedics)
    ISSUE #: 02 DOCUMENT #: HRD-F-24 Formulation DATE: 13-11-2023

    Work Achievements(Please ✓the appropriate Score


    S. No. 5 4 3 2 1 Total Score
    box) (O-S) (E-E) (M-E) (I-N) (U-A)
    1 Meet Quality of Service & Minimum Work
    Standard.
    2 Communicate Supervisor on Completion of
    Tasks.
    3 Work on Time & Meet Deadlines.

    4 Team Work & Devotion to Duty.

    5 Performance under work load.

    6 Job Knowledge / Knowledge Sharing.

    7 Submit Progress Report on Regular Basis

    8 Discuss Work Plan & Compliance.

    9 Follow Supervisor Feedback for Objective


    Fulfillment.
    10 Work as per Quality Improvement SOPS.

    Total Score
    Grand Total /100

    Rating Grade(Please ✓the appropriate box) O-S E-E M-E I-N U-A

    Justification Required in case of Out Standing & Very Poor Rating:

    Page 2 of 3
    MTI-KHYBER TEACHING HOSPITAL
    (Medical Teaching Institution)
    HUMAN RESOURCE
    Performance Evaluation Form Clinical (Doctors,
    Nursing, Paramedics)
    ISSUE #: 02 DOCUMENT #: HRD-F-24 Formulation DATE: 13-11-2023

    RECOMMENDATIONS BY HOD/ MANAGER

    Please ✓the appropriate box


    Description
    Fit for Job.

    Contract Extension Not fit for Job.

    Need Further Improvement

    Fit For Accelerated Promotion.


    Fit for Promotion on turn.
    Promotion
    Not Fit for promotion yet. (Specify if Training Required for Improvement.

    Technical Please Specify


    Trainings
    (Mandatory) Non-Technical Please Specify

    Warnings Number of Warnings Issued

    Reporting Officer:

    Name: Designation:

    Signature: Remarks. (If any)

    HEAD OF DEPARTMENT:

    Name: Designation:

    Signature:

    COMPETENT AUTHORITY:

    Name: Designation:

    Signature:

    Page 3 of 3

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