GOVERNMENT OF KERALA

DEPARTMENT OF HEALTH SERVICES

MEDICAL BOARD CONSTITUTED BY DISTRICT MEDICAL OFFICER
CONSTITUTED AS PWE GO (P) N0.202/2009/H&FWD DTD.26-06-099

APPL: NOTro)NS ei |g3506481 DATE:3

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CERTIFICATE FOR THE PERSONS WITH DISABILITIES

Signature/Thumb Impression of the candidate:

D r . H a ,

with
This is to certify that the Medica' Board constituted as certification authority toçpersons
Disabilities by the District Medical officer... ***************
.Superintendeni Medical
******
college
mined
Hospital,
of
Shri/Smt/Kumari/Master...nanclhu... ..Son/Beth*er
llcelelaaaca.. .Village
Vidyaelhuuan kResiding at..ndaloc
*****************

1Adoax. Taluk.Podhanamlhtdistrict...odANamcand found that he/she/is

Orthopedicas/Permanent/Temporary/Disability96). Words.. Ninkt peneuulasge
PsDuund Ceue
Belongs to MILD/MAODERATESEVERE/TOTAL Eategiry. oes
dentiicatior Aärks

Ablacle. Mole.on Jelt orwu ***************

Blaclemole.on de-o leKigkk incdenciug

2.
BOARD MEMBERS
Name,Designation, Reg No) seal) Signature with date
SI.No Doctors
1 Psychiatry DR. NAJEEB.SS
CONSULTANT PSYCHIATRIST
GENERAL HOSPITAL, TVM-
DE. HETEN DIANA JOSEPH MEBs, DPMR
2 Orthopaedician JUNIOR CONSULTANT (CIL SURGEON)
MR KERALAS+A+
Reg. No: 19961
EALTSERm
Ophthalmologist

Dr.Rajani Balachandran
ENT
MBBS.DLO,ONB
Junior Consultant, EN da
Reg:No: 29748
Chairman Dr.REMA.L
L.a
R a g N o : 19275
1a8a18&
C i v i l S u r g e o i

Less than 40%

Mild
40% and above
Moderate
75% and above
L.Raa
Severe CHAIRMAN 1»s{2818
100% profound
Total Medical Board

r.REM/
Reg.No 19275
Civil Surgeon
*********'*****t°********