Medical Form
1
I do hereby certify that I have examined a candidate for employment in the Department and cannot discover that he/she has any disease, constitutional affection or bodily infirmity except I do not consider this as a disqualification for employment in . the Office of .............. Signatufe of Candidate Paste photograph here Photo attested His/her age according to his/her own statement is ........ years and by appeamnce about years. He/she has a small pox/ vaccination mark. Personal marks of identification Signature : Name: Rei No. : Rank: Designation : Station : Date: Thumb lmpression attested 1) 2l Seal
-
Upload
rama-subramaniam -
Category
Documents
-
view
215 -
download
1
description
nothing
Transcript of Medical Form
-
I do hereby certify that I have examined
a candidate for employment in the
Department and cannot discover that he/she has any disease,
constitutional affection or bodily infirmity except
I do not consider this as a disqualification for employment in
. the Office of ..............
Signatufe of Candidate
Paste photograph here
Photo attested
His/her age according to his/her own statement is
........ years and by appeamnce about
years. He/she has a small pox/ vaccination mark.
Personal marks of identification
Signature :
Name:
Rei No. :
Rank:
Designation :
Station :
Date:
Thumb lmpression attested
1)
2l
Seal