Non-gazetted employees Medical certificate to return to duty on getting rid of the disease ( Fitness Certificate )
आवेदक के हस्ताक्षर ………………………………….
मैं……………………………………………………….. का सिविल सर्जन/पंजीकृत डॉक्टर (स. …………..) यह प्रमाणित करता हूं कि मैंने ………………………………..……………… विभाग के श्री ………………….…………………… की जिनके हस्ताक्षर ऊपर दिए हुए है, डाक्टरी परीक्षा सावधानी पूर्वक की है तथा इस निष्कर्ष पर पहुंचा हूं कि वह अब रोग से मुक्त है तथा इस योग्य है कि सरकारी ड्यूटी पर चले जाएं । मैं यह प्रमाणित करता हूं कि निष्कर्ष पर पहुंचने से पहले मैंने मूल डाक्टरी प्रमाण - पत्रों और उन विवरणों (अथवा उनकी प्रमाणित प्रतियो ) की जांच कर ली है जिनके आधार पर छुट्टी मंज़ूर की गई थी अथवा बढ़ाई गई थी तथा इन सबको ध्यान में रखने के बाद ही अपने उक्त निष्कर्ष पर पहुंचा हूं ।
सरकारी चिकित्सक
अथवा
पंजीकृत चिकित्सक (सं. ……..)
तारीख……………………
Non-gazetted employees Medical certificate to return to duty on getting rid of the disease
Signature of the applicant ………………………………….
I ……………………………………………………… .. Civil Surgeon / Registered Doctor (no. ………… ..) certify that I ………… ………………………………....……………… Mr. …………………. …………………… of the department whose signature is given above, the medical examination is carefully done and I have come to the conclusion that he is now free from disease and is eligible to go on government duty. I certify that before arriving at the conclusion, I have checked the original medical certificates and the particulars (or certified copies) on the basis of which the leave was granted or extended and to take these into consideration Only after I have reached my aforesaid conclusion.
Government Doctor
or
Registered Doctor (No. …… ..)
Date ……………………
Non-gazetted employees Medical certificate to return to duty on getting rid of the disease
Signature of the applicant ………………………………….
I ……………………………………………………… .. Civil Surgeon / Registered Doctor (no. ………… ..) certify that I ………… ………………………………....……………… Mr. …………………. …………………… of the department whose signature is given above, the medical examination is carefully done and I have come to the conclusion that he is now free from disease and is eligible to go on government duty. I certify that before arriving at the conclusion, I have checked the original medical certificates and the particulars (or certified copies) on the basis of which the leave was granted or extended and to take these into consideration Only after I have reached my aforesaid conclusion.
Government Doctor
or
Registered Doctor (No. …… ..)
Date ……………………
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