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Medical

This medical certificate verifies that an individual named is in good physical and mental health and free from any defects that could interfere with their studies or duties as a professional. It requires the signature of the individual and a registered medical practitioner who examined the individual and certified their health status. The certificate includes fields for the individual's name, signature, and visible identification marks as well as the examining medical officer's name, signature, seal, and registration number.

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Jeremy Montgomery
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83 views

Medical

This medical certificate verifies that an individual named is in good physical and mental health and free from any defects that could interfere with their studies or duties as a professional. It requires the signature of the individual and a registered medical practitioner who examined the individual and certified their health status. The certificate includes fields for the individual's name, signature, and visible identification marks as well as the examining medical officer's name, signature, seal, and registration number.

Uploaded by

Jeremy Montgomery
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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ADMISSION BROCHURE 2014-15

PART - E
14
Appendix 6
I certify that I have carefully examined Shri/Km/Smt.*_______________________________________ son/
daughter/wife of Shri/Smt.* __________________________________________________whose signature
is given below. Based on the examination, I certify that he/she is in good mental and physical health and is
free from any physical defects which may interfere with his/her studies including the active outdoor duties
required of a professional.
Visible Mark of Identifcation _____________________________________________
Signature of the Candidate__________________________________________
Place :
Date :
Name & Signature of the
Medical Offcer with Seal and
Registration Number
* Strike whichever is not applicable.
** To be signed by a Registered Medical Practitioner holding a Medical degree.
Note : Use photocopy of this Form
MEDICAL CERTIFICATE**
(TO BE SUBMITTED AT THE TIME OF COUNSELLING/ADMISSION)

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