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MIS 01 - (Application for Short Leave)

Date : ____________

Name : ____________________ Deptt. : _______________ Desig. : _______________


Short Leave from _________ (AM/PM) to ________ (AM/PM) for the purpose of :
_____________________________________________________. My work assigned for the period is
Period

Timings

Subject

Branch/Year

Work Assigned during the Short Leave period

Name

Signature

(Employee Signature)
(H.O.D)
(Director)
-------------------------------------------------------------------------------------------------------------------------------(OUT PASS SHORT LEAVE)
Name : _________________________ Deptt. : _______________ Desig. : __________________
Is permitted to avail Out Pass on today i.e ___________(Date) during the period : From
__________ (AM/PM) to ___________ (AM/PM).
(H.O.D)

(Director)

MIS 01 - (Application for Short Leave)

Date : ____________

Name : ____________________ Deptt. : _______________ Desig. : _______________


Short Leave from _________ (AM/PM) to ________ (AM/PM) for the purpose of :
_____________________________________________________. My work assigned for the period is
Period

Timings

Subject

Branch/Year

Work Assigned during the Short Leave period

Name

Signature

(Employee Signature)
(H.O.D)
(Director)
------------------------------------------------------------------------------------------------------------------------------(OUT PASS SHORT LEAVE)
Name : _________________________ Deptt. : _______________ Desig. : __________________
Is permitted to avail Out Pass on today i.e ___________(Date) during the period : From
__________ (AM/PM) to ___________ (AM/PM).
(H.O.D)

(Director)

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