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Fitness Certificate

This document is a Physical Fitness Certificate issued by a registered medical practitioner certifying the health status of a candidate for admission to a specific campus. It confirms that the candidate does not have any communicable diseases or bodily infirmities and includes details about their physical measurements and vaccination status. The certificate is to be submitted during the physical verification of documents for the 2024 admission process.

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sujatjose9
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153 views1 page

Fitness Certificate

This document is a Physical Fitness Certificate issued by a registered medical practitioner certifying the health status of a candidate for admission to a specific campus. It confirms that the candidate does not have any communicable diseases or bodily infirmities and includes details about their physical measurements and vaccination status. The certificate is to be submitted during the physical verification of documents for the 2024 admission process.

Uploaded by

sujatjose9
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

(CERTIFJCA n: OF' PIIYSrCA I.

F'TTNF:SS)
(To be issued b II .
Y Rcg,srcrcd Medical Practitioner nor below rhc r:1nk of a Crvrl
Surgeon raid or honornry)
l do hereby certif h An.12.A., M&h ,)
Y t at l have examincd.ltu-. / Ms. ~3(14.

tm,./D/o. Sri R,' <r


- :lu. sJJHc el a candidate selected for
admission to, Amnta J eetham, _ _ _ _ _ _ _ _campus
. Q"Vishwa Vidyap and cannot
• • or
• 1 a m 1ct1on
• constrt• utrona
discover th at he/she has any disease communicable or otherwise

bodily infinnity except_ _ _- = - - - - - - - - - - - - - -


-

1=1-is/her age, by appearance and according to his/her own statement is: ,,/o~rr'>
a/.
He/she has marks of smallpox vaccination: Ye!f.,No
Personal marks of identification:
(I) 8 m
eta c;&, d,, a lt,(J&t:vc-6 g1iJAf
""'cA~
(2)_-==fj;_m_----"'"-"-=&::....__!,.~=-......:@:;,,:,~::..__-=~:..:..'~=-==--..t;;,f/1'~/\....;l,.~f""

a. Heigh t:____ ,(--""'6 '--J1/' -------

b. Weight: 5 <i, 1 ~J
C. Chest measurement on full inspiration: g({4'Yl expiration: 1 lkm
I- (,1().1n d .
d. Acuteness of vision: cf{, In case where sight 1s corrected
with Glasses the strength of gla s for each eye.
6~
Left:_ _ _~µ:./tl---_ _ _.Right:
, Hepatitis A, B,
I also certify that be/~ as been vaccinated and had booster against Corona
TT, Typhoid, Chicken pox & Measles

Signature of the Medical Practitioner: ~


Name (In Block letters)
_-1>-<. VnvtJY -Fi~A l~Nt> ~z..
Dr. VINNY FERNANDEZ
Registration Number
MBBS
Designation Reg N0 . 96030
J
Station h~CU A.°'"
I

~ S-
I •

C'
Date oJ'f{ ,
,.., , I

(Original to be submitted during Physical Verification of Documents)

Physical Fitness Certificate_2024 Admission, June'24

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