Medical Certificate format for engineering students
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Transcript of Medical Certificate format for engineering students
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MEDICAL FITNESS CERTIFICATE FOR STUDENTS
It is certified that I have carefully examined Mr./Ms./Mrs. _______________________________
S/o D/o W/o ________________________________________.
1. His/Her health measurements are:
a) Height ______________________ cms.
b) Weight ______________________ kgm
2. Vision Test:
a) Normal Eyesight L _______________ R__________________
b) With Glass L _______________R__________________
3. Blood Test:
Blood Group_____________________
4. Age ________________
He/She has no infectious disease or mental or bodily infirmity unfitting or likely to unfit his/her
in the future for active outdoor service or proves harmful for campus (Kenway College of
Education, ABH.) environment.
I find him/her fit to take part in all activities of college.
5. Special Remarks (if any):
______________________________________________________________________________
______________________________________________________________________________
Marks of identification: ______________________________________________________________________________
______________________________________________________________________________
Thumb Impression: Date: ________________
Signature of Candidate (Signature of Gazetted Medical Officer) Signature of Parents/Guardian OFFICE SEAL
Please paste a recent
passport size photograph
environment.