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DECLARATION WITH REGARD TO MEDICAL FITNESS

I, _Vamsi Talachintala_ hereby declare that I am completely fit for the employment with Virtusa Consulting
Services Private Ltd (the company).
 
I neither have any communicable disease nor have any symptoms of bacterial or viral infections which may
be contagious.
 
I acknowledge that I have not travelled in the last 2 months to any of the countries/locations/ suspect Areas
which may have possible impact of COVID-19 (Or) I had travelled to such countries/locations/suspect places
but not reported with any of the symptoms and completed the recommended observation period, with no
such symptoms, till the date of declaration.
 
I also acknowledge that my family members /friends/ relatives/ neighbors/ with whom I had interacted in
the last 1 month had no travel history to COVID -19 affected countries after 1 st Jan 2020 and neither of
them have symptoms of possible suspect of COVID -19 or any other contagious disease.
 
Hereby I agree to undertake that I shall take all adequate measures and in case of exhibiting any such
infection symptoms / conditions, I shall notify immediately to the company and leave the workplace
instantly keeping the consideration of care and health of the other employees and further I agree that if my
declaration is found to be untrue at any stage during the employment with the company I shall be liable for
punitive action.

                                                                                            Name & Signature : Vamsi Talachintala

Signature : T.Vamsi

Witness:
(Name & Address)
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Annexure: Countries with maximum reported laboratory-confirmed COVID-19 cases and deaths. Data as of
13 March 2020* by WHO.

China Italy
Japan Spain
Singapor
e France
Australia Germany
Malaysia UK
Philippin Netherlan
es d
Thailand Sweden
Iran Denmark
Qatar Austria
Bahrain Belgium
UAE Norway
USA Canada