(See
rule 6(a)
Medical
Fitness Certificate
1.
Name
2.
Father’s Name
3.
Age
4.
Height
5.
Residential Address
6.
Mark of identification
7.
Signature / Thumb Impression
8.
X-ray report(of cough is of
more than 2 weeks duration)
9.
Stool and Urine report
10.
Whether immunised
against Cholera & Typhoid with date
Date.........................
Place......................
M.B.B.S. Medical Officer