Date:
MEDICAL FITNESS CERTIFICATE
I Dr. ..................................................................... certify that I have carefully examined Mr./Mrs.
....................................................................., Son/Daughter of
Mr./Mrs. ......................................... .............,
address:...............................................................whose signature is given below.
Based on the examination, I certify that he is in a good mental and physical health and is free
from any physical defects which may interfere with his professional work including the active
outdoor duties required for a professional purpose.
Sincerely,
Details of the Candidate Details of the Medical Officer
Blood Group: Name:
Mark of Identification: Degree:
Signature: Designation:
Reg. No.
Place: Seal