Professional Documents
Culture Documents
SIGNATURE OF CANDIDATE: ..
I / We do hereby certify that I / We have examined Thiru /Thirumathi /Selvan /Selvi
.... a
Candidate for employment under the Government / Private as .. In the . Department and signature is given above and cannot discovered that he/she has any disease, communicable or otherwise, constitutional affiliation or bodily infirmity/ except that his/her weight is in excess or / below the standard prescribed, or except.
I/We do not consider this a disqualification for the employment he/she seeks. His / Her age is according to his/ her own statement years . years. and by appearance about
I/ We also certify that he/ she has marks of small pox / vaccination: .. CHEST MEASUREMENT IN : On full expiration . Cms. Height in cms Respiratory System Difference (Expansion) . Cms. .. ..
.. .. Astigmatic/
Hypermetropic/ myopic/
(Here enter the degree of defect and the strength of connection glasses) (Hearing is Normal, defective (Much / Slight)) URINE : Albumen ii) Sugar State Specific gravity PERSONAL MARKS: 1. 2. Station : Date : Signature .. .