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Medical Certificat For Non Gazetted Officers Recommended For Leave or Extension or Commutation of Leave

The document contains various medical and leave forms used by the Government of India. The medical certificate form is used by government medical officers to certify a non-gazetted officer's need for medical leave or extension/commutation of leave. The fitness to return form certifies that an officer is medically fit to resume duties after leave. The charge report form is used when responsibility of an office is transferred from one officer to another, with details of cash and stamp balances handed over. The application for leave form contains details required from all applicants, whether gazetted or non-gazetted, including type of leave applied for and undertakings related to leave salary.

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Vishnu Painkra
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438 views7 pages

Medical Certificat For Non Gazetted Officers Recommended For Leave or Extension or Commutation of Leave

The document contains various medical and leave forms used by the Government of India. The medical certificate form is used by government medical officers to certify a non-gazetted officer's need for medical leave or extension/commutation of leave. The fitness to return form certifies that an officer is medically fit to resume duties after leave. The charge report form is used when responsibility of an office is transferred from one officer to another, with details of cash and stamp balances handed over. The application for leave form contains details required from all applicants, whether gazetted or non-gazetted, including type of leave applied for and undertakings related to leave salary.

Uploaded by

Vishnu Painkra
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Est-95

Signature of Applicant

Medical Certificat for non gazetted officers recommended


for leave or
Extension or commutation of leave

(Govt. of India Finance Department no 173-SR Dated 16


March 1931)

I ……………………….after careful examination of the case here by


certify that …………………………… whose signature is given
above is suffering from……………………………………….. and I
considered that a period of absence from duty for
………………………… with effect from…………………… is
absolutely necessary for the restoration of his health.

Date-----------------

Govt. Medical Attendant


Or

Registered Medical Practitioner (No.)

Medical Certificate of fitness to return to duty


Signatur of Applicant

I ……………………………….. Civil Surgeon of Registered Medical


Pratitioner or of do hereby certify that I have carefully
examined…………………. Of the
Department……………………………………. Whose signature is
given above and find that he has recovered from his illness and is now
fit to resume his studies in Government Service I also certify that
before arriving at this decision I have examined the original Medical
Certificates and statements of the case(or Certified copies there of) on
which leave was grated or extended and have taken these in to
consideration in arriving at my decision.
Date----------------------------------

Govt. Medical Attendant


Or
Registered Medical Pratitioner (No)
A.C.G-61 DEPARTMENT OF POSTS, INDIA
(See Rule267,Post and Telegraphs Financial Hand Book,
Volume1,Second Edition)
Charge Report and Receipt for cash and stamps on transfer of charge

Certified that the charge of the office of


……………………………
Was made over by (name)

To (name) at (place)
To (name)……………………………….
On the (date)……………………………………… _fore____noon in
accordance with

No. Dated No

Relieved Officer Relieving Officer


(P.T.O)
*Certified that the balances of this date of the several books(including
Stock book and Registers) and accounts of the office have been
checked and found correct.
*Certified that the balances as detailed below were handed over to me
by the Relieved Officer and I accept the responsibility for the same.

Cash
Stamp imprest

Made up of:-
1) Stamps
2) Cash

Relieved Officer Relieving Officer

Dated the
Forwarded
to______________________________________________________
________________________________________________________
*The certificated when not actually required may be scored through.
FORM OF APPLICATION FOR LEAVE
Note- item 1 to 11 must be filled in by all applicants, Whether gazetted or non gazetted

1. Name of applicant
2. leave rules applicables
3. Post held
4. Department , Office and Section
5. Pay
6. House rent allowance, conveyance allowance or other compensatory allowances
drawn in the present post
7. Nature and period of leave applied for and date from which required
8. Sundays and holidays ,if any proposed to be prefixed suffixed to leave.
9. Ground on which leave, is applied for
10. Date of return from last leave and the nature and period of that leave
11. I propose do not to avail myself of leave travel concession in the block years---
during the ensuing leave.\
12. I undertake to rufund the difference between the leave salary drawn during leave on
average pay/ commuted leave and theat during leave on half average pay/ half pay
leave which would not have been admissible had the provision to F.R. 81(b) (ii)
rule 11(c) (iii) of the Revised Leave Rules, 1933 not been applied in the event of
my retirement from service at the end or during the currency of the leave.
(b) I undertake to refund the leave salary drawn during leave not due which would not been
admissible had F.R.81(c) Rule 11(d) of the Revised leave Rules 1933 and not been applied in
the event of my voluntary retirement or resignation from service at any until I earn half pay
leave not less than the amount of leave not due availed by me.

Date_________________

13.Remarks and /or recommendaton of the controlling Officer.

Date________________

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