PRESCRIBED FORM OF MEDICAL CERTIFICATE OF

PHYSICALLY HANDICAPPED CANDIDATES.

 

I, Dr.______________________Regd. No.___________________have examined

Shri___________________________________ whose particulars are given below and hereby certifiy that he is a permanent physically handicapped person but does not suffer from any disease (communicable or otherwise), constitutional weakness or bodily infirmity that may interfere with the efficient discharge of his duties as (Name of the post). I do not consider this a disqualification for appointment to this post under the Government.

  1. Name of Candidate
  2. Father's Name
  3. Identification Mark.
  4. Sex
  5. Age
  6. Nature of disability

 

 

___________________
Signature of Candidate		   ________________________
Signature of Surgeon/Medical Officer
  Designation ___________________
  Office Stamp

 

 
  Address

 

 

NOTE: The word "Physical handicapped in sub-para-7(i) and Sub-para 7(viii) are applicable only in case of Group `B' Non-Gazetted posts.