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Data Base Form

The document is a database form used by the Ministry of Health to collect personal, employment, educational, and professional development information from employees. It includes sections for personal details, next of kin, employment details, qualifications, training, progression history, and transfer history. The form emphasizes the ministry's vision of a healthy nation and its core values.

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kedisangletty
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23 views4 pages

Data Base Form

The document is a database form used by the Ministry of Health to collect personal, employment, educational, and professional development information from employees. It includes sections for personal details, next of kin, employment details, qualifications, training, progression history, and transfer history. The form emphasizes the ministry's vision of a healthy nation and its core values.

Uploaded by

kedisangletty
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as ODT, PDF, TXT or read online on Scribd
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MINISTRY OF HEALTH – DATABASE FORM

PERSONAL DETAILS
Employee ID/Exemption No.:
Full Names (as per ID/Passport):
Date of Birth (DD/MM/YYYY):
Gender
☐ Male ☐ Female ☐ Other
Nationality:
Home Village:
Contact Numbers:
Email Address:
Postal Address:

(Street Address, City, Postal Code)


Physical Address:
NEXT OF KIN
Next of Kin's Full Name:
Relationship to Employee:
Next of Kin's Phone Number(s):
Next of Kin's Email Address (if available):
EMPLOYMENT DETAILS
Date of First Appointment (DD/MM/YYYY):
Employment Status:
☐ Permanent ☐ Temporary ☐ Contractual ☐ Other:
Job Title/Position (Current):
Current Salary Scale:
Date in Current Salary Post (DD/MM/YYYY):__
Department/Unit:
Supervisor's Name:
Supervisor's Email Address:__
Current Duty Station (Location/Facility):

Vision: A Healthy Nation.


Values: Botho, Equity, Timeliness, Customer Focus, Teamwork, Accountability.
MINISTRY OF HEALTH – DATABASE FORM
QUALIFICATIONS & EDUCATION HISTORY

Highest Level of Education:

☐ Doctorate/PhD
☐ Master’s Degree
☐ Bachelor’s Degree
☐ Diploma
☐ Certificate
☐ Cambridge/O'level
☐ JC (Junior Certificate)
☐ Other: _____________________________
Details of Qualifications:
 Doctorate/PhD:
Institution: _____________________________
Year Completed: _____________________________
 Master’s Degree:
Institution: _____________________________
Year Completed: _____________________________
 Bachelor's Degree:
Institution: _____________________________
Year Completed: _____________________________
 Diploma:
Institution: __
 Diploma in general nursing
Year Completed:
 Certificate:
Institution:
Year Completed:
 Cambridge/O’level:
Year Completed
 JC (Junior Certificate):
Year Completed:

PROFESSIONAL DEVELOPMENT & TRAINING


Professional Certifications/Training Completed (if any):
 Certification/Training Name: _____________________________
 Institution: _____________________________
Vision: A Healthy Nation.
Values: Botho, Equity, Timeliness, Customer Focus, Teamwork, Accountability.
MINISTRY OF HEALTH – DATABASE FORM
 Year Completed: _____________________________
Other Relevant Courses/Workshops Attended:
 Course/Workshop Name:
 Institution:
 Year Completed:
Is the employee currently on study leave?
☐ Yes ☐ No
If yes, please complete the following:
• Study Leave Start Date (DD/MM/YYYY):
• Study Leave End Date (DD/MM/YYYY
• Field of Study:
• Name of Institution/University:
• Program of Study:
• Study Leave Approval Reference No.:
• Supervisor's Contact During Study Leave (Name & Email):
• Current Duty Station (Pre-Study Leave):
PROGRESSION HISTORY
Please provide the date for each progression level you have attained during
your career.
 FO _______________________________________
 F1 _______________________________________
 F2 _______________________________________
 E1 _______________________________________
 E2 _______________________________________
 D1 _______________________________________
 D2 _______________________________________
 D3 _______________________________________
 D4 _______________________________________
 C1
 C2 _
 C3 _
 C4
 B1 __________________________________
 B2 _______________________________________
 B3 _______________________________________
 B4 _______________________________________
 B5 _______________________________________
 A1 _______________________________________
 A2 _______________________________________
 A3 __________________________________

Vision: A Healthy Nation.


Values: Botho, Equity, Timeliness, Customer Focus, Teamwork, Accountability.
MINISTRY OF HEALTH – DATABASE FORM
TRANSFER HISTORY
Please list the facilities you have been transferred to, including the dates:

Facility 1:
Facility 2:

Facility 3:

Facility 4:

Facility 5:

Vision: A Healthy Nation.


Values: Botho, Equity, Timeliness, Customer Focus, Teamwork, Accountability.

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