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Medical Form For Driving License Renewal

medical form for reneval of driving license

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Harshad Nikam
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5K views1 page

Medical Form For Driving License Renewal

medical form for reneval of driving license

Uploaded by

Harshad Nikam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
Declaration made by the applicant in Form 1 as to his physical fitness is attached Certificate of Medical Fitness | certify that : = () Ihave personally examined the ‘Shri: MANGESH TANAWADE (ii) that while examining the applicant | have directed special attention to his / her distant vision; (ti) while examining the applicant, | have directed special attention to his / her hearing abil, the conditions of the arms, legs, hands and joints of both extremities of the applicar (iv) [have personally examined the applicant for reaction time, side vision and glare recovery (applicable in case of persons applying for a licence to drive goods carriage carrying goods of dangerous or hazardous nature to human life.) ee The applicant is not medically fit to hold a licence for the following reasons : - Signature : 1. Name and designation of the of Medical Officer 1 Pracitioner ‘GONDHALE Mill BAMS [Link], 2:Registration Number of Medical Officer No. : 134412-A-1 Bee ~ eee Signature or thumb impression of the candidate (MANGESH TANAWADE ) Date: 19) 3 altg Note : - 1. The medical Officer shall affix his signature over the photograph affixed in ‘such a manner that part of his signature is upon the photograph and part ‘on the certificate. 2, Dumb persons without deafness may be granted a valid certificate of driving licence for non-transport vehicle.

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