MEDICAL FITNESS CERTIFICATE FORMAT

MEDICAL FITNESS CERTIFICATE FORMAT

MEDICAL FITNESS CERTIFICATE FORMAT

 

Registration no                 :-             …………………………………………………                 Date :- 27/10/2020

Patient Name                    :-             …………………………………………………

Date of birth                      :-             …………………………………………………

Father’s Name                  :-             …………………………………………………

Address                                               :-             …………………………………………………

…………………………………………………

 

Passport no                        :-             …………………………………………………

Identification Mark         :-             …………………………………………………

  1. Eye :
  2. ECG :
  3. X Ray Chest (PA View) :
  4. :
  5. :
  6. :
  7. :
  8. :
  9. :
  10. :
  11. G.OT :
  12. BLOOD UREA :
  13. HIV :
  14. HCV :
  15. HBV :
  16. VDRIL :
  17. URINE C/E :

 

After going through the following test I have found ……………………..(Patient Name)  S/o  ………………………….. (Patient Father’s Name) is medically fit.

 

Signature

Medical Officer

L.D. Govt. Hospital, Kashipur

Ramnagar Road, Udham Singh Nagar

Medical Fitness Certificate Format PDF File Download – Click here .

Physical Fitness Certificate in word format –  Click here.

इन लोकप्रिय ख़बरों को भी पढ़ें :

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