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Certificate of Physical Fitness

This document is a certificate of physical fitness completed by a medical officer for an individual seeking employment. It certifies that the individual was examined and no diseases or disabilities were found that would disqualify them for the position, except for any conditions listed. It provides the individual's age according to their statement and appearance. It also lists two personal marks of identification. The certificate is signed with the name, rank, designation, and date of the examining medical officer.

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2K views

Certificate of Physical Fitness

This document is a certificate of physical fitness completed by a medical officer for an individual seeking employment. It certifies that the individual was examined and no diseases or disabilities were found that would disqualify them for the position, except for any conditions listed. It provides the individual's age according to their statement and appearance. It also lists two personal marks of identification. The certificate is signed with the name, rank, designation, and date of the examining medical officer.

Uploaded by

deepusvvp
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CERTIFICATE OF PHYSICAL FITNESS BY

a single Medical Officer


the Civil Medical Board

I/We do hereby certify that I/We have examined


Sri/Smt. ................................................................................. a candidate
for employment in the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
........................... Department and could not discover that he has any disease,
constitutional affection or bodily infirmity except . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.........................................

I/We do not consider this disqualification for employment in the


office of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
..........................................................

His/Her age according to his/her own statement is . . . . . . . . . .years


and by appearance about . . . . . . . . . . . . . . . . . . . . years. He/She has mark of small pox
vaccination.

Personal marks of Identification*


1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . .
............................

2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.............................

Name :
Reg. No : President
Rank :
Designation : Members
Station :
Date :

*This should be filled in with great care after examination

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