The ANM exam pattern and syllabus vary by state, but every Female Health Worker / Auxiliary Nurse Midwife recruitment tests the same professional core from the ANM training course: community health, midwifery, child health, family planning, first aid and health programmes. This guide explains the verified structure of recent UPSSSC (UP), Rajasthan and Bihar ANM exams, the subject-wise syllabus, past paper trends and the selection process.
In this guide:
- Who conducts ANM exams
- ANM exam pattern and syllabus: state-wise
- Subject-wise ANM syllabus
- Previous paper trends (2021 to 2025)
- Selection process
- Frequently asked questions
Who conducts ANM exams
| State | Conducting body (latest cycle) | Post name |
|---|---|---|
| Uttar Pradesh | UP Subordinate Services Selection Commission (UPSSSC) | Swasthya Karyakarta (Mahila) / Female Health Worker |
| Rajasthan | Rajasthan Staff Selection Board (RSSB, earlier RSMSSB) | Female Health Worker (ANM), contractual under NHM |
| Bihar | State Health Society, Bihar | Auxiliary Nurse Midwife (ANM) |
The current status of each state is tracked in our ANM notification 2026 hub.
ANM exam pattern and syllabus: state-wise structure
UPSSSC ANM (UP): PET plus main exam
UP follows a two-step system. Candidates must first appear in the UP Preliminary Eligibility Test (PET) conducted by UPSSSC. Only PET participants with a valid score of the year named in the advertisement can apply for the post-specific main exam. For advertisement 11-Exam/2024 (5,272 Female Health Worker posts), the PET-2023 scorecard was required, and the main exam was held on 11 January 2026.
| Feature | UPSSSC ANM main exam (Advt. 11-Exam/2024) |
|---|---|
| Mode | Offline, objective (OMR) |
| Questions | 100 multiple choice questions |
| Total marks | 100 (1 mark each) |
| Duration | 2 hours |
| Negative marking | One-fourth (0.25) mark for each wrong answer, as reported |
| Content | Professional subject of the post (ANM course content) |
| Next stage | Document verification |
The PET itself is a general eligibility test (general knowledge, Hindi, English, reasoning, numerical ability and similar areas), not a nursing paper. A good PET score is only an entry ticket; final merit comes from the main exam.
Rajasthan ANM (RSSB)
Rajasthan’s last large ANM cycle was the contractual Female Health Worker (ANM) recruitment of 2023 (advertised along with GNM posts, 2,058 ANM posts in the notice). The written exam was held offline on 3 February 2024 and results were released in June 2024, followed by document verification. Coverage of that syllabus listed these areas, with health, nursing and midwifery carrying the largest share:
- Health, nursing and midwifery (professional section)
- National Health Mission programmes and schemes
- General knowledge of health care, nutrition and cleanliness
- Rajasthan general knowledge
- Current affairs
- Basic computers
RSSB papers carry negative marking and board-specific OMR rules printed on the admit card and question booklet. Confirm the exact question count, marks and deduction in the next advertisement on the official site. Our Rajasthan ANM course follows this RSSB structure.
Bihar ANM (SHS Bihar)
State Health Society Bihar advertised 5,006 ANM posts (Advt. 08/2025). The computer based test was held in December 2025, results with category-wise cut-offs came on 23 January 2026, and document verification followed from 27 January to 3 February 2026. As reported, the merit list combines CBT performance with weightage for work experience, so experienced contractual ANMs get credit for service.
Subject-wise ANM syllabus
The professional syllabus across states comes from the Indian Nursing Council ANM course. Use this table as your checklist.
| Subject | Key topics |
|---|---|
| Community health nursing | Concept of health, health care delivery system, sub-centre and PHC, role of ANM, ASHA and AWW, home visits, records and registers, community diagnosis |
| Health promotion | Nutrition and deficiency diseases, personal hygiene, environmental sanitation, safe water, health education, communication |
| Primary health care nursing | Infection control, first aid and emergencies, communicable diseases (TB, malaria, leprosy, dengue, hepatitis), common conditions, basic medications, body structure and function |
| Child health nursing | Newborn care, growth and development, immunisation, breastfeeding, diarrhoea and ORS, ARI, malnutrition, IMNCI basics |
| Midwifery | Female reproductive system, pregnancy and antenatal care, labour and its stages, postnatal care, complications and danger signs, family planning |
| Health centre management | Sub-centre management, supplies, records, supervision, team work, programmes and schemes |
| General section (state specific) | State GK, current affairs, computers; in UP, the PET covers general subjects separately |
For focused notes, use our midwifery and obstetrics notes, pediatric nursing notes, first aid and emergency notes and national health programmes notes.
PET and main exam compared (UP)
| Point | UPSSSC PET | ANM main exam |
|---|---|---|
| Purpose | Eligibility screening for many Group C posts | Post-specific merit for ANM |
| Content | General subjects (GK, language, reasoning, numerical ability and similar) | ANM professional subjects |
| Who can take it | Any eligible candidate as per the PET notice | Only candidates with a valid PET score of the year named in the advertisement who also meet ANM eligibility |
| Role in final selection | Shortlisting for the main exam | Final merit, followed by document verification |
Subject-wise high-yield areas
Within each subject, a few areas are asked again and again. Prioritise these in revision:
- Midwifery: signs and diagnosis of pregnancy, calculation of expected date of delivery, antenatal schedule and supplements, stages of labour, active management of the third stage, postpartum haemorrhage and pre-eclampsia warning signs, postnatal check-ups.
- Child health: UIP vaccines and their timing, essential newborn care, kangaroo mother care, breastfeeding, growth charts, ORS and zinc, signs of pneumonia and severe malnutrition.
- Community health: structure from sub-centre to district hospital, population norms, roles of ANM and ASHA, eligible couple register, home visit bag technique.
- Family planning: methods with their mechanism, ideal candidates and common counselling points.
- Primary health care: hand hygiene, sterilisation and disinfection, biomedical waste segregation, first aid, common communicable diseases.
- Health promotion: nutrients and deficiency diseases, safe drinking water, sanitation and health education methods.
How ANM papers have trended (2021 to 2025)
- Midwifery and child health lead: antenatal care, labour, postnatal care, newborn care and immunisation are the most consistent areas.
- Practical, field-based questions: papers increasingly ask what an ANM should do first at a sub-centre or during a home visit, not just definitions.
- Programmes and schemes: maternal and child health schemes, immunisation programme facts and disease control programmes appear regularly.
- First aid and communicable diseases: steady share, with straightforward factual questions.
- General section: in Rajasthan, state GK and current affairs add marks that often decide close ranks.
How to use previous year papers
- Solve the latest papers of your state in exam timing.
- Mark each question by subject to see the real weightage.
- Write every mistake as a one-line fact in an error notebook.
- Practise one or two papers of other states for extra professional questions.
The full study plan is in the ANM preparation strategy.
ANM selection process
- Eligibility step: in UP, appear in the UPSSSC PET; in other states, apply directly.
- Online application for the ANM post on the board’s portal.
- Written exam or CBT as per the state pattern.
- Answer key and objections.
- Result and merit list, with experience weightage where the state provides it (as in Bihar).
- Document verification of ANM certificate, nursing council registration, age, domicile and category.
- Appointment as per state rules.
Frequently asked questions
How many questions are there in the UPSSSC ANM exam?
The main exam for advertisement 11-Exam/2024 was reported as 100 questions for 100 marks in 2 hours, with 0.25 mark deducted for each wrong answer.
Is PET compulsory for UP ANM?
Yes. UPSSSC allows only candidates with a valid PET score of the year mentioned in the advertisement to apply for the ANM main exam.
Is there negative marking in the Rajasthan ANM exam?
RSSB exams carry negative marking. Check the exact deduction in the advertisement and admit card instructions of your cycle.
Which subjects carry the most weight in ANM exams?
Midwifery, child health and community health nursing, followed by family planning, communicable diseases, first aid and health programmes.
Does work experience help in ANM selection?
In some states, yes. Bihar’s 2025 ANM merit was reported to combine CBT scores with work experience weightage. Check your state notice.
Prepare with Concept RNA
Cover the full ANM syllabus with state-specific classes and practise on mocks built to the UPSSSC and Rajasthan patterns.