Format of Test-Check Report under ADIP...
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Format of Test-Check Report under ADIP Scheme Test Check (Minimum of 10/15 percent*) of beneficiaries assisted during the year 2017-18 Name of the Implementing Agency - SVNIRTAR, Olatpur PART-I State: ODISHA District: BHADRAK Sl. No. Sl. No. of list of the covered Beni. Name of Benificiary Father's/ Husband's name Male/ Femal e Age Complete Address Conta ct Numb er Type of Aid given Place of Camp Date of Camp Whether any surgical correction dertaken Date of Test Check Finding of test- check(e.g. distribution confirmed & working well/ distribution confirmed but 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1 1 SUBRATA JENA C/O-SURIYAMANI JENA, AT SANKHULA PS BHANDARI POKHAR DSIT BHADRAK M 6Y C/O-SURIYAMANI JENA, AT SANKHULA PS BHANDARI POKHAR DSIT BHADRAK - - BHADRAK 30.08.2017 BIL. CTEV. 30.08.2017 DISTRIBUTION CONFIRMED 2 2 DEBASIS BEHURA C/O SRIDHAR BEHERA AT DHUSURI PO BHADRAK DIST BHADRAK M 6Y C/O SRIDHAR BEHERA AT DHUSURI PO BHADRAK DIST BHADRAK - - BHADRAK 30.08.2017 RT CTEV 30.08.2017 DISTRIBUTION CONFIRMED 3 3 JAGANNATHA TARAI C/O RABINDRA TARAI AT PITEIPUR PS DHAMANAPUR DIST BHADRAK M 8Y C/O RABINDRA TARAI AT PITEIPUR PS DHAMANAPUR DIST BHADRAK - - BHADRAK 30.08.2017 LT. HEMIPLA GIA WITH EQUENC E LT SIDE 30.08.2017 DISTRIBUTION CONFIRMED 4 4 LAXMIPRIYA DAS C/O PRADEEP DAS AT CHARDIA PS BANSADA DIST BHADRAK F 9Y C/O PRADEEP DAS AT CHARDIA PS BANSADA DIST BHADRAK - - BHADRAK 30.08.2017 LT. CTEV 30.08.2017 DISTRIBUTION CONFIRMED 5 5 SIBA SUNDAR BEHERA C/O- UMAKANTA BEHERA AT GUNUDAPUR PS NAIKANIDIH DIST BHADRAK M 10Y C/O- UMAKANTA BEHERA AT GUNUDAPUR PS NAIKANIDIH DIST BHADRAK - - BHADRAK 30.08.2017 LT CTEV 30.08.2017 DISTRIBUTION CONFIRMED 6 6 SAMBIT ROUT C/O SOHADEV ROUT AT GOUDARIPOKHARI PS BANSADA DSIT BHADRAK M 8Y C/O SOHADEV ROUT AT GOUDARIPOKHARI PS BANSADA DSIT BHADRAK - - BHADRAK 30.08.2017 CP 30.08.2017 DISTRIBUTION CONFIRMED
Transcript of Format of Test-Check Report under ADIP...
Format of Test-Check Report under ADIP SchemeTest Check (Minimum of 10/15 percent*) of beneficiaries assisted during the year 2017-18Name of the Implementing Agency - SVNIRTAR, Olatpur
PART-I State: ODISHA District: BHADRAK
Sl.No.
Sl. N
o. o
f lis
t of
the
cov
ered
Ben
i. Name ofBenificiary
Father's/Husband'sname
Male/
Female
Age Complete Address ContactNumber
Type of Aidgiven
Place of Camp Date ofCamp
Whe
ther
any
surg
ical
cor
rect
ion
dert
akenDate of Test
Check
Find
ing
of
test
-ch
eck(
e.g.
dist
ribu
tion
conf
irm
ed &
wor
king
wel
l/di
stri
buti
onco
nfir
med
but
qual
ity
not
sati
sfac
tory
/di
stri
buti
on n
oty
conf
irm
ed e
tc.
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 1 SUBRATA JENA
C/O-SURIYAMANIJENA, AT SANKHULAPS BHANDARIPOKHAR DSITBHADRAK
M 6Y
C/O-SURIYAMANI JENA, ATSANKHULA PS BHANDARIPOKHAR DSIT BHADRAK - - BHADRAK
30.0
8.20
17
BIL.CTEV.
30.0
8.20
17
DISTRIBUTIONCONFIRMED
2 2 DEBASIS BEHURA
C/O SRIDHARBEHERA AT DHUSURIPO BHADRAK DISTBHADRAK
M 6Y
C/O SRIDHAR BEHERA ATDHUSURI PO BHADRAK DISTBHADRAK - - BHADRAK
30.0
8.20
17
RT CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
3 3 JAGANNATHA TARAI
C/O RABINDRATARAI ATPITEIPUR PSDHAMANAPURDIST BHADRAK
M 8Y
C/O RABINDRA TARAI ATPITEIPUR PSDHAMANAPUR DISTBHADRAK
- - BHADRAK
30.0
8.20
17
LT.HEMIPLAGIAWITHEQUENCE LT SIDE
30.0
8.20
17
DISTRIBUTIONCONFIRMED
4 4 LAXMIPRIYA DAS
C/O PRADEEP DAS ATCHARDIA PSBANSADA DISTBHADRAK
F 9Y
C/O PRADEEP DAS ATCHARDIA PS BANSADA DISTBHADRAK - - BHADRAK
30.0
8.20
17
LT. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
5 5
SIBA SUNDAR BEHERA
C/O- UMAKANTABEHERA ATGUNUDAPUR PSNAIKANIDIH DISTBHADRAK
M 10Y
C/O- UMAKANTA BEHERA ATGUNUDAPUR PSNAIKANIDIH DIST BHADRAK - - BHADRAK
30.0
8.20
17
LT CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
6 6 SAMBIT ROUT
C/O SOHADEV ROUTATGOUDARIPOKHARIPS BANSADA DSITBHADRAK
M 8Y
C/O SOHADEV ROUT ATGOUDARIPOKHARI PSBANSADA DSIT BHADRAK - - BHADRAK
30.0
8.20
17
CP
30.0
8.20
17
DISTRIBUTIONCONFIRMED
7 7 SASMITA DEHURY
C/O RAJENDRADEHURY ATNAAMI POBHANDARIPOKHARI DIST BHADRAK
F 10Y
C/O RAJENDRA DEHURYAT NAAMI POBHANDARIPOKHARI DISTBHADRAK
- - BHADRAK
30.0
8.20
17 RT.EQUINSFOOT
30.0
8.20
17
DISTRIBUTIONCONFIRMED
8 8 JAY PRAKASH SAMAL
C/O PITABASSASMAL ATDEHULAPAD PSBHANDARI POKHARIDIST BHADRAK
M 10Y
C/O PITABAS SASMAL ATDEHULAPAD PS BHANDARIPOKHARI DIST BHADRAK - - BHADRAK
30.0
8.20
17
BIL. CTEVEQUINS
30.0
8.20
17
DISTRIBUTIONCONFIRMED
9 9 SIPUN BEHERA
C/O- BRUNDABINBEHERA ATMANIPUR PSBHADRAK DISTBHADRAK
M 9Y
C/O- BRUNDABINBEHERA AT MANIPUR PSBHADRAK DISTBHADRAK
- - BHADRAK
30.0
8.20
17
RT. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
10 10 MANISHA JENA
C/O BALARAM JENAAT BAHUDARADADSIT BHADRAK F 10Y
C/O BALARAM JENA ATBAHUDARADA DSITBHADRAK - - BHADRAK
30.0
8.20
17
BIL. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
11 11 RITESH KU. SETHY
C/O GANGADHARSETHY AT KUMBHAKARAL PSPADHANPADA DISTBHADRAK
M 11Y
C/O GANGADHAR SETHY ATKUMBHA KARAL PSPADHANPADA DISTBHADRAK
- - BHADRAK
30.0
8.20
17
CP
30.0
8.20
17
DISTRIBUTIONCONFIRMED
12 12 SASMITA MAHALIK
C/O SUKANTAMOHALIK ATHATUANS PS TIHIDIDIST BHADRAK
F 10Y
C/O SUKANTA MOHALIK ATHATUANS PS TIHIDI DISTBHADRAK - - BHADRAK
30.0
8.20
17
RT CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
13 13 ANTARJYAMI BARIK
C/O UMESH CH.BARK ATKARANDIMAL PSCHENDABALI DISTBHADRAK
M 12Y
C/O UMESH CH. BARK ATKARANDIMAL PSCHENDABALI DIST BHADRAK - - BHADRAK
30.0
8.20
17
LT CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
14 14 ANUSAYA MUKHI
C/O NIRANJANMUKHI ATGANIGANG PSBORTH DISTBHADRAK
F 13Y
C/O NIRANJAN MUKHIAT GANIGANG PS BORTHDIST BHADRAK - - BHADRAK
30.0
8.20
17
BIL. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
15 15 JAGANNATHMAHAPRASAD JENA
C/O DASARATHIJENA ATCHUINPUR PSBHADRAK DISTBHADRAK
M 14Y
C/O DASARATHI JENA ATCHUINPUR PS BHADRAKDIST BHADRAK - - BHADRAK
30.0
8.20
17 RT.EQUINSFOOT
30.0
8.20
17
DISTRIBUTIONCONFIRMED
16 16 SANATAN DAS
C/O SARAT DAS ATNAIKANDIHI PSBHADRAK DISTBHADRAK
M 13Y
C/O SARAT DAS ATNAIKANDIHI PS BHADRAKDIST BHADRAK - - BHADRAK
30.0
8.20
17
BIL. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
17 17 SUSHANTA JENA
C/O ADIKANDA JENAAT MALADA PSBHADRAK DISTBHADRAK
M 14Y
C/O ADIKANDA JENA ATMALADA PS BHADRAK DISTBHADRAK - - BHADRAK
30.0
8.20
17 BIL.EQUNESSFOOT
30.0
8.20
17
DISTRIBUTIONCONFIRMED
18 18 SUBASH BEHERA
C/O MANULATABEHERA ATTENTULATA PSCHANDABALI DISTBHADRAK
M 16Y
C/O MANULATA BEHERA ATTENTULATA PS CHANDABALIDIST BHADRAK - - BHADRAK
30.0
8.20
17
BIL. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
19 19 RAJANDRA KU. JENA
C/O ALEKH JENAAT TARAGO POBANTA DISTBHADRAK
M 25Y
C/O ALEKH JENA ATTARAGO PO BANTA DISTBHADRAK - - BHADRAK
30.0
8.20
17
BIL. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
20 20 SASMITA JENA
C/O SURENDRA JENAAT GHATAPUR POCHADBAI DISTBHADRAK
F 19Y
C/O SURENDRA JENA ATGHATAPUR PO CHADBAIDIST BHADRAK - - BHADRAK
30.0
8.20
17
RT CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
21 21 RABINDRA KU. NAYAK
C/O NIRAKAR NAYAKAT/PO FABRAMPDIST BHADRAK M 27Y
C/O NIRAKAR NAYAK AT/POFABRAMP DIST BHADRAK
- - BHADRAK
30.0
8.20
17
LT. CTEV
30.0
8.20
17
DISTRIBUTIONCONFIRMED
Format of Test-Check Report under ADIP Scheme
