The Indira Gandhi Institute of Medical Science (IGIMS) in its form also asks the employees about the number of wives and details about the past marriages of their spouses.
Then they have to indicate if "That I am married to a person who has no other wife living" or "That I am married to a person who has another wife living" or "That I am married and have more than one wife".
The newly-formed Janata Dal-United-Bharatiya Janata Party government is yet to comment on the issue, while the state Health Department is also reluctant to say anything.
"It is embarrassing for all of us to say anything," a health official said.
However, IGIMS Medical Superintendent Manish Mandal told the media that there is nothing unusual in the form.
"The IGIMS follows New Delhi's AIIMS which in turn follows CCS rules. The form is according to prescribed rules, which are made by the government and Constitution. If they change the word, we will change it," Mr Mandal said.