The CHO exam pattern and syllabus are set separately by each state, but every Community Health Officer recruitment under the National Health Mission tests the same core: community health, maternal and child health, national health programmes and primary care skills. This guide explains the verified structure of recent CHO exams in Rajasthan and Uttar Pradesh, the common syllabus, how past papers have trended and how the selection process works.
In this guide:
- Who conducts the CHO exam
- CHO exam pattern and syllabus: state-wise structure
- Subject-wise CHO syllabus
- Previous paper trends (2021 to 2025)
- Selection process
- Frequently asked questions
Who conducts the CHO exam
CHO posts are created under the Ayushman Bharat programme to run Ayushman Arogya Mandir (formerly Health and Wellness Centres) at the sub-centre level. Recruitment is done by each state, so the conducting body changes from state to state:
| State | Recruiting / conducting body (latest cycle) | Official website |
|---|---|---|
| Rajasthan | Rajasthan Staff Selection Board (RSSB, earlier RSMSSB) for NHM Rajasthan | rssb.rajasthan.gov.in |
| Uttar Pradesh | National Health Mission, Uttar Pradesh | upnrhm.gov.in |
| Bihar | State Health Society, Bihar | shs.bihar.gov.in |
| Madhya Pradesh | National Health Mission, Madhya Pradesh | nhmmp.gov.in |
| Jharkhand | Jharkhand Rural Health Mission Society | jrhms.jharkhand.gov.in |
For the current status of each state, see the CHO notification 2026 hub.
CHO exam pattern and syllabus: state-wise structure
There is no single national CHO paper. Below are the structures reported for the two largest recent cycles. Always confirm against the official advertisement PDF of your cycle, because boards can change the pattern.
Rajasthan CHO (RSSB, 2025 cycle)
The Rajasthan CHO posts (2,634 advertised) were part of RSSB’s combined NHM and RajMES advertisement of 2025. The written exam was held on 8 June 2025 in offline (OMR) mode. As reported in coverage of that cycle:
| Feature | Rajasthan CHO 2025 |
|---|---|
| Mode | Offline, OMR based objective paper |
| Questions | 150 multiple choice questions |
| Total marks | 450 (3 marks per question) |
| Duration | 150 minutes |
| Negative marking | 1 mark deducted for each wrong answer |
| Sections | General knowledge, general science and current affairs; general Hindi and English; NHM and introduction to RMNCH+A; computer knowledge; topics related to the professional qualification (largest share) |
RSSB exams also carry board-wide instructions on unattempted questions and OMR filling, printed on the admit card and question booklet. Read them carefully on the day.
UP CHO (NHM UP, 2024 advertisement)
NHM UP advertised CHO posts in January 2024 and reopened applications from 28 October to 17 November 2024, raising the posts to 7,401. Coverage of that advertisement describes a computer based test (CBT) followed by document verification:
| Feature | UP CHO (2024 advertisement, as reported) |
|---|---|
| Mode | Computer based test, bilingual (Hindi and English) |
| Questions and marks | 100 questions, 100 marks |
| Duration | 2 hours |
| Sections | Section I: professional knowledge (80 marks); Section II: general aptitude, reasoning, general awareness and basic computers (20 marks) |
| Negative marking | None reported |
| Next stage | Document verification |
Verify these figures in the official advertisement on upnrhm.gov.in before relying on them, as we could not confirm a CBT date for this cycle at the time of writing.
Other states
Bihar, MP and other states also run objective written tests (often computer based) followed by document verification, and some states add weightage for experience. Their question counts and marking vary by cycle, so check the advertisement of your cycle rather than older figures shared online.
Subject-wise CHO syllabus
The professional syllabus across states is drawn from the B.Sc Nursing community health content and the Certificate in Community Health (CCH) curriculum. The table lists the common units and what to focus on.
| Unit | Key topics |
|---|---|
| Basics of the human body | Anatomy and physiology of major systems, normal vital signs, normal lab values |
| Public health and community health nursing | Concepts of health, levels of prevention, epidemiology, health indicators, health care delivery system in India, roles of CHO, ANM, MPW and ASHA |
| Maternal health | Antenatal, intranatal and postnatal care, high-risk pregnancy, danger signs, safe abortion, maternal health schemes |
| Newborn and child health | Essential newborn care, IMNCI, immunisation, growth monitoring, breastfeeding and complementary feeding |
| Family planning and adolescent health | Temporary and permanent methods, eligible couples, adolescent health programmes |
| Communicable diseases | TB, malaria, dengue, leprosy, HIV, diarrhoea, respiratory infections: spread, incubation, prevention and treatment protocols |
| Non-communicable diseases | Hypertension, diabetes, common cancers screening, mental health, elderly care |
| Nutrition | Nutrients, deficiency disorders, anaemia, malnutrition, supplementation programmes |
| National health programmes and NHM | NHM structure, RMNCH+A, UIP, TB elimination, vector-borne disease control, NCD programme, Ayushman Arogya Mandir service packages |
| Primary care skills and emergencies | First aid, triage, wound care, burns, poisoning, bites, referral |
| Pharmacology | Essential medicines at the health centre, drug classes, routes, side effects |
| General section (state specific) | State GK, current affairs, Hindi and English, computers, reasoning |
Our community health nursing notes, national health programmes notes, obstetrics notes and nutrition notes cover these units in exam format.
How CHO papers have trended (2021 to 2025)
Looking at state CHO papers from recent years at a qualitative level, a few patterns are clear:
- Programmes and MCH dominate: immunisation, antenatal care, newborn danger signs, family planning and programme facts appear in almost every paper.
- Shift to applied questions: candidates of the 2025 Rajasthan exam described the professional section as moderate to difficult, with more conceptual and clinical scenario questions than plain one-liners.
- Current programme names matter: questions use updated names and guidelines, so outdated notes cost marks.
- General section is not a formality: in Rajasthan it is a meaningful part of the total and often decides close merit positions.
- Repetition of concepts, not questions: the same topics return each year with new framing.
How to use previous year papers
- Solve the last three to four papers of your state under timed conditions.
- Tag each question by unit to see where the weight lies.
- Move every wrong answer into an error notebook as a one-line fact.
- Solve one or two papers of neighbouring states for extra practice on the professional section.
The full study plan is in our CHO preparation strategy.
CHO selection process
- Online application on the state portal (for Rajasthan, through SSO Rajasthan for RSSB).
- Written test or CBT as per the state pattern.
- Answer key and objections released by the board.
- Result and merit list, category-wise and area-wise where applicable (Rajasthan publishes separate lists for scheduled and non-scheduled areas).
- Document verification of education, registration, domicile and category certificates.
- Bridge course or training where required: for example, Rajasthan’s 2025 notice required candidates without a CCH or equivalent to complete a six-month bridge course.
- Posting at an Ayushman Arogya Mandir on contract as per NHM terms.
Frequently asked questions
Is there negative marking in the CHO exam?
It depends on the state. The Rajasthan 2025 paper was reported with 1 mark deducted for each wrong answer out of 3, while coverage of the UP 2024 advertisement reported no negative marking. Check your official notice.
How many questions are asked in the Rajasthan CHO exam?
The 2025 RSSB CHO paper was reported as 150 questions for 450 marks in 150 minutes. Future cycles may change, so confirm in the next advertisement.
Is the CHO syllabus based on the CCH course?
Largely yes. The professional section follows community health and CCH content: MCH, family planning, diseases, nutrition, programmes and primary care skills.
Do GNM nurses need a bridge course to become CHO?
Some states require it. Rajasthan’s 2025 notice required a six-month bridge course for selected candidates without a CCH or equivalent certificate, while UP’s 2024 notice required integrated CCH in the degree itself.
Where can I practise CHO-pattern questions?
Use state-pattern mocks such as the CHO test series and solve previous papers of your state.
Prepare with Concept RNA
Cover every unit of the CHO syllabus with state-specific classes and practise on mocks that follow the Rajasthan and UP patterns.