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Medical Examination Report for Candidates

The document is a medical examination report that outlines the general expectations for candidates, including requirements for vision, hearing, and absence of certain medical conditions. It includes sections for personal history and declarations by the candidate, as well as detailed medical assessments to be completed by a registered medical practitioner. The final certification indicates whether the candidate meets the physical fitness standards for admission to an engineering or science course.

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BIBEKANANDA PAL
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80 views2 pages

Medical Examination Report for Candidates

The document is a medical examination report that outlines the general expectations for candidates, including requirements for vision, hearing, and absence of certain medical conditions. It includes sections for personal history and declarations by the candidate, as well as detailed medical assessments to be completed by a registered medical practitioner. The final certification indicates whether the candidate meets the physical fitness standards for admission to an engineering or science course.

Uploaded by

BIBEKANANDA PAL
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

MEDICAL CERTIFICATE

MEDICAL EXAMINATION REPORT


(To be filled and signed by the candidate)

Entry No. 2 0 2 5

GENERAL EXPECTATIONS

Candidate will have good general physique with

(a). Vision : Should be normal, In case of defective vision it should be corrected to


6/9 in both eyes or 6/6 in the better eye.

(b). Hearing : Should be normal. Defective hearing should be corrected.

(c). Heart and : Should not have any abnormality and no history of mental disease
Lungs or Epileptic fits.

PERSONAL HISTORY

1. Name.

2. Father/Guardian’s Name
3. Age Year Months Date of Birth
4. Sex
5. Identification Mark on the Body (This can
be a mole, scar or birthmark)
6. Major illness/operation:
(Specify nature of illness/operation)

6(a) Declaration by student: I am not suffering from any chronic illness like Epilepsy, Bronchial
Asthma etc.

Signature of the Candidate

18
MEDICAL CERTIFICATE

MEDICAL EXAMINATION REPORT


(To be issued by a Registered Medical Practitioner)

(Item 7-19 to be filled by Medical Officer conducting the Medical examination)

7. Height cm. 8. Weight Kg.


9 Past History 10. Chest
(a) Mental Disease (a) Inspiration cm.
(b) Epileptic fit (b) Expiration cm.
11. Vision with or without glass 12. Hearing

(a) Right eye 13. Abdomen


(b) Left eye (a) Liver
(c) Color Blindness (b) Spleen

14. Respiratory system 15. Nervous system


16. Blood Group
17. Heart
(a) Sounds 18 (i) Hernia
(b) Murmur (ii) Hydrocele

19. Any other defects


Certified that son/daughter of

a) fulfills the prescribed standard of physical fitness and is FIT for admission to
engineering/science course.

b) does not fulfill the prescribed standard of physical fitness and is unfit/ temporarily unfit for
admission due to following defects:

Signature of the Medical Officer


Date

Regn. No.

SEAL

19

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