[Translator’s notes appear in square brackets]

[Personal information has been redacted.]


Islamic Republic of Iran

Decision of the Personnel Office


Form: A32 (52-4) – Department of State for Administration and Employment Affairs

1. Ministry/Institution: Regional Health Organization of Tehran Province

2. Employee Number:

3. Given name: Mrs /Mr: Dr. Ataollah

4. Surname: Eshraghi

5. Father's name: Mohammad-Hosein

6. Birth Certificate number and place of birth: Birth certificate number: [redacted], Issued in: [redacted]

7. Place of birth: [redacted]

8. Date of birth: 8 Shahrivar [redacted] [30 August [redacted]]

9. Highest level of education and field: Doctorate, Field: Medicine

10. Title of permanent position: General practitioner

11. Guild: Health, Rank: Medical, Level: ---

12. Group/rank: 10

13. Base: Grade 6

14. Section: Health district of Karaj

15. Location of service: Fateh Polyclinic, Township: ----, Division: ----, Town: Karaj, Province/Region: Tehran

16. Basis: -----, date: -----, number -----

17. Type of order/verdict: Dismissal from employment

18. Details of Decision:

In compliance with instruction number 7560,  dated 10 Dey 1359 [31 December 1980] from the Minister of Health, and in accordance with reference 21029 issued by the Ministry Office, as well as article 6 of the Employment and Social Security Bylaw, this order is hereby issued for your dismissal from employment with the regional Health Organization of Karaj:

(1) Your years of services will be calculated in accordance with the Employment Act.

(2) From the date of the enforcement of this order, you will have no position in Karaj.

(3) Furthermore position [number] 2 of Fateh Polyclinic shall be declared vacant.

19. Salaries, benefits, and bonuses: [blank details]

20. Salaries, benefits, and burnouses indicated in this decision, for the total sum of (in letters) ----- rial are payable subsequent to legal reductions from credit --- Section, Article ---

21. Date of enforcement of decision: 1 Shahrivar 1360 [23 August 1981]

22. Date of issuance of decision number: 26 Mordad 1360 [17 August 1981], Number 11453;

23. Given name and surname of Officer in Charge: Dr. Safavi [signature].

24. Title of permanent organizational position: Director of the Regional Health Organization of Karaj.

[Original] copy – Employee


[Handwritten notes, number and date at the bottom of the page]

To Dr. Eshraghi, for information