CERTIFICATE OF PHYSICAL FITNESS

I do certify that I have examined………………………………………………………… a candidate for employment

in the Manappuram Comptech and Consultants Ltd, and could not discover he/she has any
disease, constitutional affliction

or bodily infirmity except……………………………………………………..................................... I do not consider this

as a disqualification for employment in the office of Manappuram Comptech and Consultants

Ltd . His/her age according to his/her own statement is………………………years and by appearance
looks………………………..years.

Physical Examination

1 Anaemia Yes No
3 Clubbing Yes No
2 Cyanosis Yes No
4 Odema Yes No
5 Blood pressure
6 Pulse
7 Abdomen and pelvis Normal Abnormal
8 Cardiovascular system Normal Abnormal
9 Respiratory system Normal Abnormal

10 Nervous system Normal Abnormal

11 Ear/Nose/Throat /Eye Normal Abnormal
12 Is he/she a diabetic Yes No

If diabetic, how long if under medication; OHA/Insulin

13 Any physical deformity noticed? …........................................................................................................................

IDENTIFICATION MARKS

1 ……………………………………………………………………………………………………………………………………………………………………………....

2 ……………………………………………………………………………………………………………………………………………………………………………….

Place : Signature :

Date : Name :

Designation :

Seal :