THE FUNDAMENTAL RULES OF THE TAMIL NADU GOVERNMENT

Form under Fundamental Rule 10.(For use in other case.)Certificate of Physical Fitness bya single Medical Officer/the Civil Medical BoardI/We do hereby certify that I/we have examined (full name)acandidate for employment under the Government of Tamil Nadu in the service asand cannot discoverthat he/she has any disease, communicable orotherwise, constitutionalaffliction or bodily infirmity except that his/her weight is in excess ofthe standard prescribed, or exceptI/We do not consider this a disqualification for the employment he/she seeks.His/Her age is according to his/her own statementyears.smallpoxI/We also certify that he/she has marks of -------------vaccinationon full inspirationChest measurement in centimetersHeight in Centimetres.Weight in Kilograms.His/Her vision is normalHypermetropic ( )on full expirationdifference (expansion)(Here enter the degree of defect and the strength of correction glasses.)Myopic ( )(Here enter the degree of defect and the strength of correction glasses.)Astigmatic (simple or mixed) ( )(Here enter the degree of defect and the strength of correction glasses.)Hearing is normal, defective (much or slight).in excess of/Belowyears and by appearance aboutUrine—Does chemical examination show (i) albumen, (ii) sugar, state specific gravity.Personal marks (at least two should be mentioned).Signature*Rank:Designation:Station:Date:‡President.Members (i)(ii)StationDated215