You are on page 1of 1

To the Medical

Officer

From (Designation)

*Mr./Mrs./Miss
Please examine the above named as to *his/her fitness for appointment as
a on * Operational Service/
Permanent and Pensionable terms.

Date..20..

Signature

PART B
MEDICAL CERTIFICATE
(To be completed by a Medical Officer)
I have examined the above named and consider that *he/she is/is not
physically fit for appointment.
Date.20 Signature
Station.. Designation..

You might also like