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Medical 1

This medical certificate is required for admission to GLA University, Mathura, and must be completed by a qualified medical officer. It includes personal details, medical history, and a general examination of the candidate, confirming their fitness for studies. The document emphasizes the importance of addressing any significant medical issues that may affect future employment prospects.

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2K views1 page

Medical 1

This medical certificate is required for admission to GLA University, Mathura, and must be completed by a qualified medical officer. It includes personal details, medical history, and a general examination of the candidate, confirming their fitness for studies. The document emphasizes the importance of addressing any significant medical issues that may affect future employment prospects.

Uploaded by

skshukla1371944
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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MEDICAL CERTIFICATE

(To be obtalned from a Medlcal Offlcer having minimum M.B.B.S. degree)


This certificate has to be aubmitted by the student at the tlme of taking admlsslon in GLA University, Mathura
Personal Dotalls
Nane of Cantitate AbtIYA SU KLA Gender: Male
ather Name Date of Birth Blood Group
thers Name o409)2006 A
Yo1SNA SHUKLA
Modlcal Hlstory
Surgervracture Blood Transfuslon NO

Heyatitis Pulmonary Koch's


hpertsion Dlabetes Melitus
Alkergies Asthma Selzures

ADIIvA SHUKLA solemnly affirm that the detalls of my medical history supplied by me to the doctor
are aurate to the best ot my knowledge, Ishall bo solely hold responslble for any discrepancies therein.

Sigrrature of Candidate
Date: t<os)24 General Examinatlon

Pulse 2minute BP_[Du_o_mmHg Weight |_kg Height 9_cms

Pallor
lcterus Lymphadenopathy
Systemlc Examination

Central Nervous System NAD DOTEn


Cardiovascular System
Respiratory System
Musculoskeletal System
Genitourinary System
Abdomen

Skin Hair
Eyes
Ears

blindness /depression /psycho


Any other significant findings (please specify any findings related to colour
logicalbehaviour or any other medical issue, if found)

Certified that the candidate is fit/unfittemprarily tnfitto pursue his/her studies.

of Medical ficer
4-824
Date:
MCVState Medical Council Registration Number 32121(v.P)
and st¡l
SignaturgMBBS.
32129 (UP)
MicuiCie)
Reg. No.
Note: Keeping in view future employment prospects and selection in organizations/companies, candidates
are advised toget any visual, speech, hearing or loco-motor impairments further evaluated by relevant
medical/ surgical specialists.

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