prospectus download - Uckkr.org
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Annexure-XVII<br />
MEDICAL CERTIFICATE FOR DIFFERENTLY ABLED<br />
OFFICE OF THE CHIEF MEDICAL OFFICER _________________<br />
No. ____________________<br />
Dated ______________<br />
Certified that Sh./Km./Smt _______________ son/daughter/wife of Sh. ____________________ resident of<br />
___________________________ District __________________________ appeared before the Medical Board<br />
for medical check up. On his/her Medical Examination, it is found that the nature of Differently Able/disability<br />
is______________% and (as applicable), is as under :<br />
1. Blind or Low vision_____________________________________________________<br />
2. Hearing impairment_____________________________________________________<br />
3. Locomotor disability/cerebral palsy_________________________________________<br />
Thus the candidate is Differently Abled as per standard norms of Haryana.<br />
(Signature of the Applicant)<br />
Dated : ____________<br />
Place : ____________<br />
Chief Medical Officer<br />
___________, Haryana<br />
*The Differently Abled disability should not be less than 40% and should not interfere with the<br />
requirement of professional career such as Engineering/Architecture/Technician etc.<br />
-------------------------------------------------------------------------------------------------------------------------------------<br />
Annexure-XVIII<br />
CERTIFICATE TO BE FURNISHED BY<br />
CHILDREN/GRAND CHILDREN OF FREEDOM FIGHTER<br />
Certified that Mr./Ms.___________________ son/daughter of Shri _____________________ resident of<br />
(Complete address) __________________________Freedom Fighter of Haryana (Identity No. _______) is<br />
father/grandfather of Mr./Ms.____________________________ of village/Town ___________________ Police<br />
Station _______________________Tehsil _________________ District_________________<br />
No. :_____________________<br />
Dated:___________________<br />
Place: ___________________<br />
Deputy Commissioner of concerned<br />
District of Haryana<br />
(Office Stamp)<br />
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