LARKANA: Health Department Additional Secretary (PH), Dr. Muhammad Aslam Pechuho, has directed Section Officers (SOs) of his department to prepare the working paper for promotion of doctors in the next higher grade, against the vacancy positions and newly proposed under 4-tier formula and submit the same for approval of Health Secretary, Dr. Fazalullah Pechuho, at the earliest in pursuance of the Supreme Court of Pakistan. He has also narrated the proposed upgradation of the 4-tier formula, according to which 943 posts of general cadre doctors have been proposed to be upgraded from BS-17 to BS-18, 1100 posts have been proposed to be upgraded from BS-18 to BS-19 and 51 posts have been proposed to be upgraded from BS-19 to BS-20. Likewise, 42 posts of Dental Surgeons have been proposed to be upgraded from BS-17 to BS-18, 33 posts have been proposed to be upgraded from BS-18 to BS-19 and nine posts have been proposed to be upgraded from BS-19 to BS-20. In education Services, as many as 16 posts have been proposed to upgrade from BS-17 to BS-18, 10 posts of BS-20 have been proposed to be downgrade, out of which five posts have been proposed to be downgraded to BS-18 and five posts to BS-19.