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Form of Medical Certificate

The document is a medical certificate confirming that Smt. has been examined and found free from any diseases or physical defects that would disqualify her for Government Service. It includes details about her vision standards and confirms her physical fitness for the position of Woman Civil Excise Officer. The certificate must adhere to specific guidelines regarding the presentation of vision standards to be accepted.

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shahidimamdcs
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95 views1 page

Form of Medical Certificate

The document is a medical certificate confirming that Smt. has been examined and found free from any diseases or physical defects that would disqualify her for Government Service. It includes details about her vision standards and confirms her physical fitness for the position of Woman Civil Excise Officer. The certificate must adhere to specific guidelines regarding the presentation of vision standards to be accepted.

Uploaded by

shahidimamdcs
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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FORM OF MEDICAL CERTIFICATE

I have this day medically examined Smt..................................................................


(Name and address) and found that she has no disease or infirmity, which would
render her unsuitable for Government Service. She is free from physical defects like
knock knee, flat foot, varicose vein, bow legs, deformed hands and limbs, irregular and
protruding teeth,defective speech and hearing.

Her age according to her own statement is ......................................... and by


appearance is ............................. and her standards of vision is as follows.

Standards of Vision
(without glasses)
Right Eye Left Eye

(i)Distant Vision .............Snellen ................... Snellen


(ii)Near Vision ................Snellen ...... ............ Snellen
(iii)Field of Vision .....................
( Specify whether field of vision is full or not. Entries such as Normal, Good etc. are
inappropriate here)
(iv)Colour Blindness................................
(v)Squint................................
(vi)Any morbid condition of the eyes or lids of either eye ...............
She is Physically fit for the post of Woman Civil Excise Officer in the Excise
Department.

Place: Signature
Date : Name and Designation
of the Medical Officer

(Office Seal)

Note: Details regarding standards of vision should be clearly stated in the Certificate
as given above and vague statement such as Vision Normal/good will not be
accepted. Specification for each eye should be stated separately. If the specification
are not as indicated above, the officer issuing the Certificate should certify whether
the candidate has got better standards of vision or worse standards of vision as the
case may be, otherwise the Certificate will not be accepted.

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