P ECUS ROSP T - Maharshi Dayanand University, Rohtak

Appendix-EOFFICE OF THE CHIEF MEDICAL OFFICERNo: ...................................... Dated: ......................................Certified that Sh./Km./Smt………....…………………………………………………………………………….Son/daughter wife of Sh…………………………………………resident of........…..……...…………………District …………………….....…………………......… appeared before the Medical Board for medical checkup.On his/her Medical Examination, it is found that the nature of handicap/disability is …….....………. % and (asapplicable), is as under: -i) He/She is blind or Low vision……………….....…..…..ii) He/She is having hearing impairment………………….iii) He/She is having locomotor disability …………..…….. or Cerebral Palsy.PLACE: .......................................DATE: .......................................Chief Medical Officer.................…………….Haryana(Signature of the Applicant)(Seal of the above authority)APPENDIX-FCertificate For Children of Grand Children of Freedom FightersCertified that Sh./Km/Smt.____________________________________________________________________Son/daughter wife of Sh.______________________________________________________________________resident of ________________________________________________________________ (Complete address),Freedom Fighter of Haryana (Identity No. ___________________________________________) is father/grandfather of Sh./Km./Smt _________________________________________ (Name of candidate) of village/Town______________________________________________ Police Station________________________________Tehsil _________________________ District __________________________, State _____________________No :……….…………………………………Date : ...………………………………….........Place : ………………………………………....Deputy Commissioner ofConcerned District of Haryana(Seal of Office)26