MEDICAL NOC APPLICATION Medical Cell, DGCA (Opp Safdarjung Airport), Aurobindo Marg New Delhi ~ 110 003 Date: ISSUE OF NOC FOR CONDUCT OF CLASS-I MEDICALS 1 \, (Name), PMR No 4-,...d..0-L-2 request for an NOC since (state reason(s) why NOC is required) 2. Mydetails are as follows (2) Emaitid (®) Contact Number () Postal Address (@) Age (e) Details of last medical Date Place of Medical ‘Type of Medical Class-1/ Class-2 «eens Status Fit/ Temporary Unfit! Permanent Unf () Forthcoming Medical Date Place 3, have not exercised the privileges of my license wien my medical was not valid. 4, NOC maybe eect 1 option) posted to me/ sent slongwith PMY held at DCA fr collection by m ‘Yours faithfully, Enclosures 1) Copy of Last Medical Assessment issued by DGCA ( If not received, then CA-35 issued by Boarding Centre) 2) Copy of License 3) Copy of 1" & last page of log book 4) Documents supporting reason for delay e.g. medical cerlificates if reason was medical REMARKS BY JDMS (CA)