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Medical Certificate for NEET UG 2023 qualified candidates
Roll No ...................................................... .
Application No ................................................
NEET UG 2023 combined merit rank ...................................... .
I_, Dr ........................................................... have examined Sri/Smt
Son/daughter of ........................................................ , residing at
................................... [Verified from Aadhar card/passport/voter
card/school or college ID card], a candidate for admission into the
Medical/ Dental UG degree colleges in West Bengal for2023- 24
admission session and observed as follows:-
1. Personal mark of identification..............................................................
2. Apparent age ................................ years
3. Any history of Pulmonary Tuberculosis ......... yes/no (put tick to
appropriate one)
4. Chest measurement:
a. Normal respiration ................................. cm
b. In Full inspiration ................................... cm
c. In Full expiration .................................... cm
5. Height ................................................... cm
6. Weight .................................................Kg
7. BMI ..................... ..
8. Eye sight visual acuity:
a. Right eye ........... ..
b. Left eye ................ ..
c. Colour blindness ...... present/absent ( put tick to appropriate one)
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9. Immunization status ................................... ( whether up to date
as per latest National Immunization Schedule)
10. General physique ............................ ..
[Link] .................................. .
12. Lungs .................................................. .
13. Abdominal viscera .................................................. .
14. Blood Group ................................ .
15. Any neurological deficits ·················································
16. Any orthopedic disability ············································
I do hereby certify that I cannot discover that he/she has any disease
physical and or mental that makes him/her unsuitable to continue
s t u d y i n g UG Medical / Dental c o u r s e.
I consider the above candidate FIT/ UN FIT to join his/her Medical or Dental UG
institution.
Date ................. .
Place .................... .
Signature of Registered Medical Practitioner
Registration No .................................................................
Council of registration ................... .
Contact No .............................................................. .
SEAL
(Candidate to paste recent passport
Size photograph on which
Medical practitioner has to attest)
