Application should be addressed to the Senior Superintendents / Superintendents of the

respective Divisions and Asst. Director (Rectt),O/o the CPMG{For PA(CO/RO) and
PA(SBCO)} only
ANNEXURE III .
PART A

PROSPECTUS FOR RECRUITMENT OF POSTAL ASSISTANTS/SORTING ASSISTANTS

IN KERALA
The details in this prospectus are applicable for the recruitment of the following posts.
(a) Postal Assistants in Post Offices
(b) Postal Assistants in Circle Office and Regional Offices
(c) Postal Assistants in Savings Bank Control Organisation
(d) Sorting Assistants in Railway Mail Service

1. Pay Band Rs 5200-20200 + Grade Pay Rs 2400/- + admissible allowances

2. PROBATION: The candidates selected will be appointed and will be on probation as per rules
till the successful completion of probation as per rules.
3. ELIGIBILITY CONDITIONS
3.1 Age: (a) Between 18 to 25 years as on last date prescribed for receipt of application as shown in
the advertisement and in the list containing vacancy position supplied with this prospectus.
Upper age limit is relaxable for-
(a) SC/ST 5 years
(b) OBC by 3 years
(c) Physically handicapped by 10 years, and
(d) Ex-Servicemen by the length of military service plus three years.
3.2Educational and other qualification required:-
(a) Postal/Sorting Assistants
(i) Pass in 10+2 or 12th Class Examination of a recognized University or Board of
School education or Board of Secondary Education (excluding vocational streams)
(ii) Candidates for the posts of Postal Assistants in Post Offices, Sorting Assistants in
Railway Mail Service and Postal/Sorting Assistants in Army Postal Service should
have the above educational qualification with English as a compulsory subject.
(iii) The candidates should have knowledge of local language of the State, i.e. should
have studied Malayalam and/or any other local language declared as local language
by Kerala State Government) as a subject at least unto Matriculation level. (SSLC)
(iv) Candidates with higher qualifications are also considered. But they have to fulfill
the requirements mentioned in Sub paras (i) to (iii) above.
(v) Candidates who have passed vocational courses or Job Oriented Courses (JOC)
only are NOT eligible.
(vi) Desirable qualification: - Typing knowledge and Computer knowledge.
(vii) For Postal Assistants of Circle office and Regional Office typing skill in Hindi at
the speed of 25 words per minute or in English at the speed of 30 words per minute
and Computer Knowledge are essential.
(b) Postal Assistant in Army Postal Services:-
(i) Applications should be super scribed as “APPLICATION FOR POSTAL
ASSISTANT to Army Postal Service” and sent to the Chief Postmaster General,
Kerala Circle, T-695033
 (ii) The vacancies reserved for APS are open only for males.
(iii) The candidates should produce a medical certificate in prescribed format available
in this prospectus at Appendix I from a Government Medical Officer.
(iv) All other conditions applicable to Postal /Sorting Assistants mentioned in sub para
(a) above will apply.
(v) Special items and conditions for Postal Assistants in Army Postal Services.
 The selected candidates will be given provisional appointment and sent to the
nearest Branch Recruiting Officer (BRO) for Physical and medical check up.
 Candidates found to be physically fit by the BRO will only be considered for
appointment and further deputation to Army Postal Service as per their
seniority in merit list. Candidate who are not found physically and medically fit
by BRO will not be appointed. They will have no right to claim any
appointment either in civil or in APS, even if they are in merit list for APS.
 Candidates declared physically fit by BRO as indicated above will be given
appointment order by the appointing authority.
 The candidates have to fulfill the required medical and physical standards
prescribed by the Army Headquarters. The selected candidates will be
governed by Army Act and Army rules during their service in APS, which
entails Field service anywhere in India or aboard, wearing of uniform as
applied to Army personnel and appropriate rank structure. The initial induction
will be in the rank of Warrant Officer.
 Selected candidates have a liability to serve in the Army Postal Service for as
long as their services are required by repatriation to civil appointment can be
done only with consent of both parties. Viz., civil appointing. Authorities and
army Postal Service.
 The selected candidates will undergo Basic Recruit Training APS Centre,
Kamptee for a period of six months, appointments is subject to successful
completion of training.
 If candidate is found to be “Unlikely to become an efficient soldier”, his
training will be terminated and appointment order issued to the candidate will
be treated as cancelled.
 A waiting list will be maintained to replace the candidates who are medically
disqualified during medical examination. The next candidate according to the
merit will be selected as replacement.
3.3PHYSICAL HANDICAPPED (PH) (COLUMN 7)
(i) Applicants may apply to the Divisions where vacancies have been reserved under PH
Quota. Application to be super scribed as “Application for Recruitment Under PH
Quota”
(ii) The recruitment of persons with disabilities will be governed by Government
Instructions issued from time to time.
(iii) Physically handicapped candidates should produce handicapped certificate from Medical
Board attached to the special employment exchange and vocational rehabilitation centre
in the prescribed from I or II, as the case may be as furnished in Appendix IV. The
Selection of the candidates is liable to be cancelled if it is found later on that they do not
come under the category of physically handicapped as defined in the relevant orders.
(iv) The vacancy position attached with this prospectus indicates the category of physically
handicapped persons who can apply for the post reserved. Only such applicants who
come under the category and within the intensity of the disability can apply supported by
requisite certificate.
 .
3.4 EX-SERVICEMEN:
a) Ex-servicemen may apply to the divisions where the vacancies have been reserved under
Ex-service quota. Application to be super scribed as “APPLICATION FOR
RECRUITMENT UNDER EX-SERVICEMAN”. Attested copy of discharge certificate
should be enclosed.
b) Armed Forces Personal applying for civil posts under ex-serviceman category should submit
the certificate in the following Proforma along with the application.
I hereby, with the information available, certify that
Sri............................................................... (Name) No..................................... (Rank)
....................................................... would complete. Prescribed period of appointment
on............................................. (dates)”
Place:
Date: Signature
Commanding Officer
Office Seal
(c) The Ex-Servicemen should apply in the separate application form available in this
prospectus furnishing all the details as required.
[Link]
1. No person-who has entered into or contracted a marriage with a person having spouse
living
or
2. No person-who has a spouse living has entered into or contracted a marriage with any
person, shall be eligible for appointment to service, Provided that Central government
may, if satisfied that such marriage is permissible under the personnel law applicable to
such person and to the other to the marriage and there are other grounds for so doing,
exempt any person from the operation of this rule.
[Link] OF SELECTION
5.1 The aggregate marks for selection will be 100, consisting of 40% weightage of percentage of
marks secured in 10 + 2 or 12th Class, 50% weightage of marks secured in aptitude test and
10 marks for computer test. (including typing skill on computer)
5.2 A merit list of candidates will be prepared on the basis of marks in the aggregate secured by
them in 10 + 2 or 12th Class Examination of a recognized University or Board of School
Education or Board of Secondary Education (excluding vocational streams). This merit list is
on the basis of 40% of the percentage of marks secured by the candidates in 10+2 or 12th
Class Examination. For example, if a candidate has secured 70% marks in 10+2 or 12th Class
Examination he would be awarded 40% of 70 i.e, 28 marks for the purpose of preparing
merit list.
5.3 Out of this merit list, candidates equal to 10 times of vacancies (For each community
separately as per the vacancies reserved for each community) will be called for to appear for
the aptitude test/written test. The candidates selected will be addressed to appear for the
Aptitude test. Those who desire to appear for the Aptitude Test should credit an examination
fee as under: -
i. Rs.100/- for general candidates.
ii. Rs.50/- for schedule castes/scheduled tribes/OBC/Ex-Servicemen/Physically
handicapped candidates in any Post office and produce the receipt at the time of
appearing for test.
 5.4 The aptitude test will contain 50 objective type questions of 2 marks each and will include
questions on English, Mathematics, General knowledge and reasoning and analytical
ability. The duration of the test will be 60 minutes. 50% of the marks secured in aptitude
test will be given weightage for the final assessment.
5.5 The computer test consists of data entry knowledge and typing knowledge on computer.
The test will consists of one passage in English or Hindi to be typed to test the typing
knowledge (The passage for type test will be consist of 450 words in English and 375
words in Hindi to be typed at the minimum speed of 30w.p.m.) and data consisting of
figures and letters to test the knowledge of data entry. The test shall be for 30 minutes-15
minutes for each part, i.e, typing knowledge and data entry and each part shall be given 5
marks each. Marks shall be given at 0 or 5 based on whether the candidate achieves
minimum standard or not. There will not be graded marks. The weightage for computer test
will be 10 marks.
5.6 The marks secured in computer test will be added to the marks already secured in the
components referred to in paras 5.2 and 5.4 above and a final merit list will be prepared.
The final selection will be made on the basis of this final merit list.
5.7 Attendance in aptitude test and computer test (including typing skill is mandatory for
selection. Those who fail to appear for these tests will not be selected.
6. SPECIAL INSTRUCTION TO THE APPLICANTS:
(i) The aptitude test for all Divisions/Units in the circle will be held on the same day and at
the same time. Hence even if a candidate applies for different divisions/Units, he/ she will
be considered only for the Division/Unit in which he/she takes the test. (b) Original
certificate should not be submitted. Only attested Xerox/Photo copies should be sent.
(ii) All the required documents and certificates should be sent along with the application. The
documents/mark lists/certificates submitted at a later date will not be entertained.
(iii) Only short-listed candidates will be informed to appear for tests and finally selected
candidate only will be informed of their selection. No correspondence will be entertained
regarding applications/selections.
(iv) Community certificate for SC/ST & OBC in the prescribed form from the competent
authorities as in Appendix II and III respectively are to be submitted. Certificates
submitted in any other form or from authorities not competent to issue the same will be
ignored.
(v) The applications should be sent through speed post/registered post only. Those sent
through any other means and given by hand will not be accepted.
(vi) Applications wrongly addressed or received after due date are liable to be rejected,
whatever may be the reason for delay. Applications without required certificates and
incomplete applications are liable to be rejected. No intimation will be sent in this regard.
(vii) The nature of work in the Railway Mail Service requires rotation of duties including night
shifts/detention on overtime duty in the exigencies of service.
(viii) Those selected candidates for the post of Postal Assistants in Post Offices and Sorting
Assistants in Railway Mail Service are require to undergo induction training at any one of
the Postal Training Centres or any other place as directed by the appointing authority.
(ix) The selected candidates of all posts are liable to serve anywhere in the circle and in Army
Postal Service in India or aboard as and when required at the sole direction of the
appointing authority.
(x) The candidates selected for the post of Postal Assistants in Savings Bank Control
Organisation are liable to be posted to any Head Post Office in the Circle.
(xi) No traveling allowances or other expenses will be paid or arrangements made for stay for
attending tests. Candidates have to bear their own cost and make their own arrangements
for stay.
(xii) Selection of candidates to various posts will be in accordance with the relevant
recruitment rules and administrative instructions issued by the Department of Posts from
time to time.
(xiii) The Department reserves the right either to revise the number of vacancies or to cancel the
recruitment if so warranted and the Department will not be liable to return the fee or pay
any compensation on the applicant‟s application.
7. DETAILS OF ENCLOSURES
(List of attested Xerox copies of Certificates and documents to be sent)

(a) All marks lists of Education qualifications

(b) Proof for Date of Birth
(c) Medical Certificate given by the Government Medical Officer in the prescribed format as in
Appendix I for candidates applying for Postal/Sorting Assistants/Army Postal Service.
(d) Caste/Community Certificate in the prescribed form SC, ST and OBC candidates issued by
competent authorities. (Please see Appendix II and IIIa)
(e) 2 Pass Port Size Photographs (one to be pasted on the application and the other sent loose
with name and address written on the reverse)
(f) Physically Handicapped Certificate from the competent authority in case of physically
handicapped candidates. (Please see Appendix IV)
(g) Discharge certificate in case of ex-servicemen or prescribed certificate in case of serving
Armed Forces Personnel, if any.
(h) Duly filled in Application form itself.
The application in the form attached to this prospectus, completed in all respects may be sent to
the officer of concerned Division/Unit as at col.10 of VACANCY POSITION chart, Vacancy
Position chart is supplied along with prospectus and application form. The application along
with attested copies of requisite certificates should reach on or before the date mentioned in the
vacancy position chart. Applications received after due date are liable to be rejected.

8. IMPORTANT
a) Original certificate should Not be submitted. Only certified copies should be submitted.
However, SC/ST/OBC/PH & Ex-servicemen candidates should produce relevant original
certificates at the examination centre for claiming examination fee concession.
b) If the prescribed/required documents are not submitted along with the application,
application will be rejected and no request for revival will be considered.
c) Incomplete or unsigned applications or applications with out photographs/late applications
will be rejected.
d) Before submitting his/her application, the candidate must carefully read the eligibility
conditions and satisfy himself that he fulfils all the eligibility conditions for the post for
which he has applied.
(e) For Postal Assistant/Sorting Assistant posts, the candidates who come under the zone of
consideration will be called for the written aptitude test. Each such candidate will be issued
with a Hall permit and will be assigned a Roll number. The Hall Permit will be sent to the
candidates in due course. Time table and venue of the examination will be indicated in the
Hall permit. However candidates can sit for the examination only on payment of the
prescribed examination fee.
9. INSTRUCTION RELATING TO SUBMISSION OF APPLICATION
(i) Write the required information in English or in Hindi
(ii) One envelope should contain application of one candidate only
(iii)The envelope containing the application must be super scribed in bold letters as
“Application for recruitment of .................................................... (Post for which applied)
(iv) An application will be rejected at any stage of recruitment process for not having been
submitted in the official format/having incomplete information/wrong
information/misrepresentation of facts/unsigned/without photographs/not accompanied by
attested copies of required certificates.
(v) If a candidate has changed his/her name or dropped/added part of his/her name after
Matriculation/SSC/Hr. Secondary or he/she has changed his/her name after Matric etc,
proof for the change in name such as Affidavit, Gazette Notification, etc., should be
enclosed.
NOTE: Only certificates issued by the competent authorities, for example, the
universities/concerned Boards would be accepted as Prof. for having possessed the
minimum educational; qualifications or date of birth. Only those certificates issued by the
competent authorities and in the prescribed form would be considered.
10. CHECK LIST: Before submission of application the following points may be checked
carefully and the corresponding columns are filled correctly.

(a) Check whether you have firmly pasted your Passport size Photograph (5cm x 7cm) in the
prescribed place in the application form.
(b) Check your Eligibility carefully.
(c) Check whether you have filled in all the columns of the application form correctly and no
column has been left blank.
(d) Check whether you have filled in your Community/Category Status correctly in the
relevant column.
(e) Check whether application form has been signed in full by you.

ABBREVIATIONS USED IN THE PROSPECTUS MEAN THE FOLLOWING

OC Other Community
SC Scheduled Caste
ST Scheduled Tribe
OBC Other Backward Classes
OPH Orthopaedically Handicapped
HH Hearing Handicapped
VH Visually Handicapped
EX-SM Ex-Serviceman

THE CHIEF POSTMASTER GENERAL

KERALA CIRCLE
THIRUVANANTHAPURAM -695033
*****
 APPENDIX – I
MEDICAL CERTIFICATE FROM GOVERNMENT MEDICAL OFFICER TO
BEPRODUCED BY THE CANDIDATES APPLYING FOR THE POSTS
OFPOSTAL/SORTING ASSISTANTS IN ARMY POSTAL SERVICE.
(TO BE WRITTEN IN THE HANDWRITING OF THE DOCTOR ISSUING THE CERTIFICATE)
Certified That I, Dr. ................................................................................................ has examined
Sri ................................. son of ......................... resident of.................................................. and
found him medically fit and fulfilling the following physical requirements for recruitment in Army.
(a) Physical standards*
Height ” ...............................cms
Weight ” ...............................cms
(b) Acuity of visionChest ” .................................cms

(i) Visual acuity not less than 6/12 each or right eye
6/6 and left eye 6/24 (ii) In a left handed individual who shoots from the
left shoulder, the visual standards for the two eyes
will be reversed.
(c) He is not suffering from any of the following disabilities:
(i) Colour blindness
(ii) Hearing Problems fars to de-waxed/cleaned before testing)
(iii) Low/high blood pressure (normal blood pressure 120/80)
(iv) Knocking knee
(v) Flat foot
(vi) Parrot chest
(vii) STD
(viii) Piles
Place :
Date : Signature of Government Medical Officer
Designation Stamp
Office Seal

Caution: As the candidate will be subjected to a medical examination by the Army Medical corps.
The Govt. Medical Officer issuing the certificate will take due care before issuing the
certificate.
* The minimum Physical Standard required is as follows:

Height Weight (kgs) Chest (cms)

(f) J &K, HP Punjab Hills
163 48 77
(g) Nagaland, Manipur, Tripura, Mizoram
Meghalaya, Assam, Arunachal Pradesh
Sikkim and Hill Region of West Bengal 157 48 77
(h) Punjab, Hariyana, Chandigarh 170 50 77
(i) Eastern UP Bihar, West Bengal, Orissa 169 50 77
(j) MP, Gujarat, Maharashtra 167 50 77
(k) Andhra Pradesh, Karnadaka,Tamilnadu,
Kerala, Goa and Pondicherry 165 50 77

(The above medical certificate does not render the candidate medically fit for employment
in Army Postal Service. It will be submitted to Army Medical Corps and candidate will be
considered fit if declared so by the army Medical Board after medical examination)
 APPENDIX – II
FORM OF CASTE CERTIFICATE AS PRESCRIBED IN M.H.A, [Link].42/21/49/N.G.S.
DATED 28-1-1952, AS REVISED IN DEPT. OF PERSONNEL & ADMINISTRATIVE
REFORMS, LETTER NO.36012/6/76-EST, (S.C.T.) DATED 29-10-1977, TO BE
PRODUCED BY A CANDIDATE BELONGING TO A SCHEDULED CASTE OR
SCHEDULED TRIBE IN SUPPORT OF THIS CLAIM.
Form of Caste certificate
1. This is to certify that Sri*/Srimati*, Kumari*............................................................................
Son/daughter* of...............................................village/town*................................. in District/
Division*....................................... of the Sate/Union Territory*.................................. belongs to
the...................................... caste/tribe* which is recognised as a Scheduled Caste/ Scheduled Tribe*
under.

The Constitution (Scheduled Castes) Order, 1950

* The Constitution (Scheduled Tribes) Order, 1950

* The Constitution (Scheduled Castes) (Union Territories) Order, 1951

* The Constitution (Scheduled Tribes) (Union Territories) Order, 1951

[As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification Order)
1956, the Bombay Reorganisation Act, 1960, the Punjab Reorganisation Act, 1966, the State of
Himachal Pradesh Act, 1970, the North-Eastern Areas (Reorganisation) Act, 1971 and the
Scheduled Casts and Scheduled Tribes Orders (Amendment) Act, 1976]
* The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956

* The constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by
the Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1956

* The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962

* The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962

* The Constitution (Pondicherry) Scheduled Castes Order, 1964

* The Constitution (Uttar Pradesh) Scheduled Tribes Order, 1964

* The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968

* The Constitution (Nagaland) Scheduled Tribes Order, 1970

* The Constitution (Sikkim) Scheduled Castes Order, 1978

* The Constitution (Sikkim) Scheduled Tribes Order, 1978

* The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989

* The Constitution (Scheduled Castes) Orders (Amendment) Act, 1990

* The Constitution (Scheduled Tribes) Order Amendment Act, 1991

* The Constitution (Scheduled Tribes) Order Second Amendment Act, 1991
2. This certificate is issured on the basis of the Scheduled Castes/Scheduled Tribes Certificate
issued to Sri/Srimati*....................................................................................................... father/
mother* of Sri/Srimati/Kumari*..................................................................................................of
Village/Town ............................................................. in District/Division*................................
of the State/Union territory.........................................................................who belong to the
Caste/Tribe* which is recognised as a Scheduled Caste/Scheduled Tribe* in the Sate/Union
Territory*............................................... issued by the ............................date
...................................

3. Sri/Srimati/Kumari*................................................................................. and /or* his/her*

family ordinarily reside (s) in
village/town*................................of.........................District/Division*of the State/Union
Territory*of .......................................

Place: Signature

Date: Designation

(with seal of Office)

Sate/Union Territory
Note: The term “ordinarily resides” used here will have the same meaning as in section 20 of
the Representation of the people act, 1950.
*Please delete the words which are not applicable
The under mentioned authorities have been empowered to issue caste Certificates of
verification

1. District magistrate/Additional District magistrate/Collector/Deputy Commissioner/

Additional Deputy Commissioner/Deputy Collector/1st class Stipendiary Magistrate/Sub
Divisional Magistrate/Taluka Magistrate/Executive Magistrate/ Extra Assistant
Commissioner.
2. Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate
3. Revenue Officer not below the rank of Tahasildar.
4. Sub Divisional Officer of the area where the candidate and/or his family normally resides
 APPENDIX – III

FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD

CLASSES (OBC) APPLYING FOR APPOINTMENT TO POSTS UNDER THE
GOVERNMENT OF INDIA

(GOVERNMENT OF INDIA, DEPT. OF PERSONNEL AND TRAINING,[Link].36033/28/94-

ESTT. (RES.) DATED 2-7-1997)

This is to certify that Sri/Srimati/Kumari*......................................son/daughter* of....................... of

Village...........................District/Division*..................................... in the Sate .....................belongs
to the ............................ community which is recognized as a Backwards Class under-

*(i) Government of India, Ministry of Welfare, Resolution No.12011/68/93-BCC (c), dated the
10th Sep.1993
(ii) Government of India, Ministry of Welfare, Resolution No.12011/9/94-BCC, dated the 19th
Oct, 1994, published in the Gazette of India. Extraordinary, Part-I Section I, No.163, dated the
20th October, 1994
(iii) Government of India, Ministry of Welfare, Resolution No.12011/7/95-BCC, dated the 24th
May, 1995, published in the Gazette of India, Extraordinary, Part-I, Section- I, No.88, dated
the 25th May, 1995
(iv) Government of India, Ministry of Welfare, Resolution No.12011/44/96 BCC, dated the 6th
Dec, 1996 published in the gazette of India, Extraordinary, Part-I, Section- 1, No.210, dated the
11th December, 1996

Sri/Srimati/Kumari*..........................................................and/or his family ordinarity reside (s) in

the ....................................... District Division* of the .....................................State. This is also to
certify that he/she does not belong to the persons/sections (Creamy Layer) mentioned in Column 3
of the Schedule to the Government of India, Department of Personnel and Training,
[Link].36012/2293-Estt (SCT) dated 8-9-1993
Place: Signature of District Magistrate

Date: Seal Deputy Commissioner etc.

*Strike out whichever is not applicable
NOTE:
(a) The term „Ordinarity‟ Used here will have the same meaning as in Section 20 of the
Representation of the People‟s Act, 1950
(b) The Authorities competent to issue caste certificate are indicated below.
(i) District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/
Additional Deputy Commissioner/Deputy Collector/1st Class Stipendiary Magistrate/
Sub Divisional Magistrate/Taluka Magistrate/Executive Magistrate/Extra Assistant
Commissioner (not below the rank of first class Stipendiary Magistrate)
(ii) Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency
Magistrate.
(iii) Revenue Officer not below the rank of Tahasildar and
(iv) Sub Divisional Officer of the area were the candidate and/or his family normally
resides.
 APPENDIX – IV
MEDICAL CERTIFICATE TO BE PRODUCED BY THE HYSICALLY
HANDICAPPED CANDIDATES
Photograph
FORM -1 of the
candidate
FORM OF MEDICAL CERTIFICATE FOR THE ORTHOPAEDICALLY
HANDICAPPED

(Note:- An Orthopaedically handicapped person is one who has a minimum of 40% Physical defect or
deformity which causes an interference with normal functioning of bones, muscles or joints as mentioned
in the Department of Personnel and Training‟s OM No.36035/5/88-Estt(SCT), dated 4.5.1990)

Certified that I, Dr.........................................Registration No......................./or*we, the members of the

Medical Board attached to the Special Employment Exchange for physically handicapped/ vocational
Rehabilitation Centre for physically handicapped ............................have this day (date)
................................. examined the applicant whose particulars are given below and that he/she falls within
the above definition.

1. Name of the candidate [Link] mark 3. Sex

4. Fathers Name 5. Approximate Age
6.(A) Nature of disability
(a) Clinical diagnosis
(b) Brief description of the disability
(c) How far disability is likely to interfere in the normal discharge of duties of Group „C‟ non-
technical posts in Government Office
(d) The degree of permanent disability according to the Manual for orthopaedic surgeon in
evaluating permanent physical impairment published by Artificial limbs Manufacturing
Corporation of India. GT Road, Kanpur 208016
(B) Use of Appliance (Tick relevant from following list)
7. Any operation done or indicated
8. Ant other disability that the surgeon might like to point out

Signature of Candidate (Signature of Orthopaedic Surgeon)

Designation
Place: Office Stamp
Date: Address
OR
Signature of Chairman
Member
Medical Board attached to special Employment Exchange for the handicapped or Vocational
Rehabilitation Centre for the Physically Handicapped.
Place:
Date: Office Stamp

NOTE-1: Medical Certificate submitted by the candidates from Orthopaedic Surgeon would be referred to
Medical Board for clearance
NOTE-2: Medical certificate submitted by the candidates from the Medical Board attached to Special
Employment Exchange for Physically Handicapped or attached to VRC for Physically
handicapped persons will be accepted straightway.
NOTE-3: All the columns in the certificate should be filled in incomplete certification are table to be
rejected disqualifying the certificate for consideration.
*Strike put whichever is not applicable.
 FORM – II Photograph
of the
FORM OF MEDICAL CERTIFICATE FOR THE DEAF candidate

Certified that I, Dr................................... Registration No......................./or* We the members of the

Medical Board attached to the Special Employment Exchange for the physically
handicapped/Vocational Rehabilitation Centre for physically handicapped...................................
have this day (date).......................... examined the application whose particulars are given below.

1. Name of the candidate 2. Identification mark

3. Sex 4. Father‟s Name
5. Approximate age
6. An estimate of the Residual hearing if any and the basis on which this estimate has been
arrived at

(i) Right ear (ii) Left ear

7. On set of deafness (Please state whether deafness is from birth or acquired later if it has been
caused afterwards, the age and cause of deafness may be indicated)
8. Please state clearly whether the candidates is deaf for the purpose of appointment as LDC
equivalent posts.
Signature of Candidate
(Signature of ENT Specialist)
Place: Designation:
Date: Office Stamp
OR Address:
Signature of Chairman:
Member:
Medical Board attached to special Employment
Exchange for the Handicapped or Vocational
Place: Rehabilitation Centre for the Physically
Date: Handicapped
Office Stamp:

NOTE-1 : Medical Certificate submitted by the candidates from ENT Specialist would be referred
to Medical Board for clearance.
NOTE-2 : Medical certificate submitted by the candidates from the Medical Board attached to
special Employment Exchange for physically Handicapped or attached to VRC for
Physically handicapped persons will be accepted straightway.
NOTE-3 : All the columns in the certificate should be filled in. Incomplete certificates ate liable to
be rejected disqualifying the candidate for consideration.

*Strike out whichever is not applicable.