Scribd
Upload
1K views

Est 95

1) The document is a medical certificate for a non-gazetted government officer applying for leave or an extension of leave. 2) It certifies that the applicant, whose signature is provided, is suffering from [blank] and that an absence from duty of [blank] period is necessary for the restoration of their health. 3) Upon return, a second certificate must be provided certifying that the applicant has recovered from their illness and is fit to resume their government duties, and that the original medical certificates were reviewed in making this determination.

Uploaded by

Ganesh Srinivasan
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
1K views

Est 95

1) The document is a medical certificate for a non-gazetted government officer applying for leave or an extension of leave. 2) It certifies that the applicant, whose signature is provided, is suffering from [blank] and that an absence from duty of [blank] period is necessary for the restoration of their health. 3) Upon return, a second certificate must be provided certifying that the applicant has recovered from their illness and is fit to resume their government duties, and that the original medical certificates were reviewed in making this determination.

Uploaded by

Ganesh Srinivasan
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
You are on page 1/ 1

.~ t~~ ~ ~.,.

~
~1. ~b
Est. 95

.Mahanagar Telephone Nigam Limited Mumbai


3ll<fGCf> ~ffl ct .
Signature of Applicant

31'<I\ilqf~1d ct>4i1IR41 ~ ~ ~" 3T~ ~ 3T~ ~ ~~ m~ ~Q)IR~


m'fR>IT ~I<tc-t) 1J1ITUT-tBi
. Medical Certificate for non-gazetted officer recommended for leave or extension or
commutation of leave
(11R(f ~. f<tt:r ~. ~~ ~1.9~-~. 3TR. ~ 9f. lffif. ~q,~~)
(A Govt. of India Finance Departmeht, No, 173-S. R. dated 16 March, 1931)

If ClQRt>~It1~ ~ ~ lJ.cfq; ~ ~
~ vrrT.J m ct mG ~ l;Pil~1d CfRffi t ~ftm ct>4i11-t) ct ~ffl ~ ~ t. Cffi .
. : ~ ~lT ~ lffi'T t 31'\,< If ~Si$lt11 t fcf> ~ ~ ct ~ .
............................~ ~ ~ ~ ~ (fq) ~ tR ~ \ifAT ~ ~ ~ 31ICl~~ct>~ I
I. after careful examination of the case hereby certify that
.................................................... whose signature is given above is suffering from and
is considered that a period of absence from duty of with effect from is
absolutely necessary for the restoration of his health.

~ '< ct>Ixl Rl fchctl ct>


3T~ 3Rl -q\ifr~a ClQq~I~ct> Rlfchctlct>
Govt. Medical Attendent
~
or
Date : . Registered Practitioner (No.

xTTf ~ 1jm IDq ~il lR cnfim UJR c6 ~ ~~ ~llfUT-tJ?T


Medical Certificate of fitness to return to duty

3TT<lGQ7 c6' ~ffl .


Signature of Applicant

If <PT~ ~/~G ~
(. ) ~ QSiI~It1 CfRffi t fcf> ~-;l ~ cfi
J5fi ~. ~ ~ffl ~ ~ S~ -g, ~I(fc-t) ~en ~m-;fi ~q)
~t a~ ~ tR ~"iIT ~ ~ Cffi 3f(f ~lT ~ 1jm t a~ ~ ~ t ~ ~'<ct>I~ ~ \R T.ffi ~ I
If ~ '4T QSiI~1d Cf>'<W~ ~ ~ tR ~~ ~ ~ if;l ~ ~I<tc-t) ~prruT-l:f5I1 3tT'< \'R' ~q,<o~ (3T2Tm
~ QJiI~It1 mwrr) ~ \JliT.J qffi (>ft t ~ 3TTtIR tR ~~ Tfu&'< ~ ~ ~/3T2fCfT ~ ~ ~. (f~
~ ~ tlWf i'i "ffiR ct mG. tl m \1U> ~ tR ~"iIT Ii I
Civil Surgeop
I. :.... do certify that' have carefully
Registered Medical practitioner of
examined of the Department. : whose
signature is given above. He has recovered from his illness and is now fit to resume his duties in Government
Service. I also certify that before arriving at this decision I have examined the original medical certificate and statement
of the case (or certified copies thereof) on which leave was granted or extended and have taken these into consideration
in arriving at my decision.

(I
~ '<ct>I-t) Rl fchctl ct>
3T~ 3Rl ~(f ClQq~I~ct> ~.TCf>
Govt. Medical Attendent
~
~ ID,~~~~ _ or

You might also like