PHYSICAL FITNESS CERTIFICATE

For admission

To be obtained only from Gazetted Government Medical officer/Medical Officer of a Government Undertaking.

Name(in Block Letters).......................................................................................................................

Father’s Name : ........................................................................................................................................

Blood group:……………………………………………………………………………………………………………………………………………..

Height : .........................................................................

Weight ................................................................

Chest:..........................................................................................................................................................

Vision : L : ...................................................... R : .....................................................................................

Colour Vision : ...........................................................................................................................................

Hearing : ....................................................................................................................................................

Allergies, if any………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………….

Any other Remarks : ………………………………………………………………………………………………………......................... ……………………………………………………………………………………………………………………………………………………………….

I, Dr……………………………………………………………………………………………………after careful personal examination of the case do hereby certify that Sri./Kumari……………………………………………………………………........................ is found physically fit to undergo professional education.

                                                                                                                                                                                                                                                  Signature with seal:

Place:                                                                                                                                                                                                                                        Reg. No.:

Date:                                                                                                                                                                                                                                         Designation

Click Here to download the medical form medical form.pdf