ELIGIBILITY CERTIFICATE
1. This is to certify that Mr./Miss/Mrs……………………………………. is the son/daughter/widow/wife
of No…………………..Rank …………………Name………………………………………............. is an Indian
National.
2. His/Her date of birth as recorded in the service document and Matriculation certificate is
……………………………………………………………………….
3. The above named individual: Passport size
photograph of
Priority-I :Widows/Wards of Defence personnel killed in action. the child to be
attested by
Priority-II :Wards of disabled in action and boarded out from service CO/OC
. Unit/ZSB/RSB
Priority-III :Widows/Wards of Defence personnel who died while in service
with death attributable to military service.
Priority-IV :Wards of disabled in service and boarded out with disability attributable to
military service.
Priority-V :Wards of Ex-Servicemen and serving personnel who are in receipt of Gallantry
Awards.
Priority-VI :Wards of Ex-Servicemen.
Priority-VII : Wives of:
(i) Defence personnel disabled in action and boarded out from service.
(ii) Defence personnel disabled in service and boarded out with disability attributable
to military service.
(iii) Ex-servicemen and serving personnel who are in receipt of Gallantry Award.
Priority-VIII : Wards of Serving Personnel.
Priority-IX : Wives of Serving Personnel.
4. Mr/Miss/Mrs…………………………………………..Son/Daughter/wife/widowof No ………………..
Rank ……………….Name………………………………….is eligible for Nomination as a Govt. of India
nominee under Ministry of Defence quota for admission in Medical/Dental Colleges in Priority-____.
File No :______________ ______________________
Dated: ZSB/CO/OCUnit/OIC Record
Stamp
COUNTERSIGNED
___________
Dated: Director RSB
Stamp
__________________________________________________________________________
Note:
For serving personnel (Under Priority V, VII, VIII & IX). Eligibility certificate to be signed by
CO/OC Unit and OIC Record only.
