Report of the examining authority
(Qo be filed in for every medical examination whether intial or periodical or re -examination or after
‘curelcontrol of disability).
Annexure to Certificate No.2°2009.2.. as result of medical examination on 2E—Olp~ 201
Identification Mark...
Left thumb impression ofthe candidate
General_development: Good / Fair Poor
Height: 32-3 ems
Weight, Some KG
Eyes:
(Visual acuity - Distance vision (wih or without glasses) Right Eye.G/. Lett Eye E16.
). Any organic disease ofthe eyes nes
(iil) *Night blindness = — Wo
(v) "Colour blindness. — Wo
(v) *Squint — No
5 fobs ose eects
)) Hearing Right ear_.INSRMEH..Lettear NER MPL
i) Any organic disease NO
6. Respiratory system
Chest measurement
(i) After full inspiration ..
(i)_ After full expiration
7." Circulatory system
Blood Pressure 12> /SO
cms
cms.
Pulse
8 Abdomen:
Tendemess NO
Liver Nore
Spleen NoMa
Tumour
9, Nervous system
History of fits or epilepsy = {/O
Paralysis RID
Mental health Geom
10. Locomotor System Wee h
11. Skin HEAT
12. Hema Ni
13, Hydrocele "Ni
14. Any other abnormality No
18, Urine:
Reaction ABee ny Cree
bane —
Sugar es :
16. Skiagrem of chest! jvormar— 9s
47. Any other °C” test considered necessary by i@bxamining authority — WO
18, Any opinion of specialist considered necessary" NO
pe ser CoM.
BASHA MEDAL CEE
2IPage