(ANNEXURE - 1) DIRECTORATE GENERAL OF HOME GUARDS & CIVIL DEFENC) NISHKAM SEWA BHAWAN, RAJA GARDEN, NEW DELHI _ 110027. - MEDICAL CERTIFICATE (TO BE ISUED BY THE DOCTOR OF GOVT. HOSPITAL/DISPENSARY/MBBS DOCTOR) 1 NAME, _S/0,DIO, W/O, _ _ _ 2, ADDRESS. _ _ — AFFIX A ws RECENT PHOTOGRAPH 3. WEIGHT _ | WITH NAME & | DATED 4, EYE SIGHT a) WITH SPECTS _ b) WITHOUT SPECTS. oe ©)COLOUR BLINDNESS * (i) YES (i) NO 5. BLOOD PRESSURE. BLOOD GROUP__ 6. GENERAL HEALTH CONDITION _ {a)GOOD —(b) AVERRAGE —(c) POOR = . IDENTIFICATION MARK, IDR. CERTIFY THAT THE CANDIDATE HAS BEEN EXAMINED BY ME & FOUND MEDICALLY FIT/UNFIT FOR HOME GUARDS. ORGANISATION AS VOLUNTEER. = DATE SIGNATURE OF CANDIDATE SIGNATURE. NAME OF MEDICAL OFFICER DISIGNATION/REGISTRATION NO. WITH STAMP. NOTE:-PLEASE THAT ASKING FOR THIS MEDICAL EXAMINATION DOES NOT MEAN THAT THE CANDIDATE HAS FINALLY BEEN SELECTED FOR ENROLMENT IN HOME GUARDS ORGANISATION AS VOLUNTEER. & (65)