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Annexure- VIMEDICAL FITNESS CERTIFICATE

(To besubmitted only alongwith appeal for re-medical examination)

Space for photograph ofcandidate

Thumb impression ofcandidate

Certified that Mr./Ms. _________________________S/O Shri________________________age__________years, a candidate of____________________________ whose photo and thumb impression are appended aboveduly attested by me was examined by me at Hospital ____________________ on date________________________.

2. I, the undersigned, have the knowledge that Mr./Ms. _________________________S/O Shri ______________________________ has been declared medically unfit by theMedical Officer for the post of__________________in ITBP due to________________________________

In my opinion, this is an error of judgment due to followingreasons:_______________________________________________________________.

3. After due examination, I declare him/her medically fit for the said post.

Date:

Signature & Namewith seal of MedicalPractitionerRegistration No.__________________

(MCI/State MedicalCouncil)Address_________________________________

Signature of the candidate

Attested by the Medical PractitionerSignature & seal

Note: The findings of the Medical Practitioner should be supported by Medicalreports/documents wherever applicable.

Davp-19112/11/505/1314

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Annexure V

FORM OF CERTIFICATE TO BE SUBMITTED BY THE CANDIDATESTHOSE WHO INTEND TO AVAIL RELAXATION IN HEIGHT OR

CHEST MEASUREMENT(Please refer para7 of the advertisement)

Certified thatShri__________________S/O Shri________________is

permanent resident of village______________________PO_______________

Tehsil/Taluka_____________District____________of ______________State.

2. It is further certified that: Residents of entire area mentioned above are considered

as___________(Garhwali, Kumaoni, Dogra, Maratha, Sikkimies)for relaxation in height measurement for recruitment in the ParaMilitary Forces of the Union of India.

He belongs to the Himachal Pradesh/Jammu & Kashmir/NorthEastern States which is considered forrelaxation in heightmeasurement for recruitment in the Para Military Forces of theUnion of India.

He belongs to ____________________Tribals/Adivasiscommunity which is considered for relaxation in height and chestmeasurement for recruitment in para-military forces.

Date: _____________________Signature ___________________

Place _____________________District Magistrate/Sub-Divisional Magistrate/Tehsildar

Delete whichever is not applicable.