MEDICAL CERTIFICATE OF FITNESS FOR ENROLMENT AS HOME GUARD VOLUNTEER
1. Name of Candidate:-
2. Registration No.:-
3. Date of Birth :-
4. Sex:- Male / Female
5. Marital Status:- Married/ Unmarried
6. Marks of identification
1. ______________________________________________
2. __________________________________________ ___
I (candidate) declare that I have never been pronounced unfit for
Government Employment by duly constituted Medical Board or Medical
Authority.
Sign Signature of the Candidate: _____________________Left Thumb impression
(To be signed and taken in the presence of examining medical board/officer)
The Board hereby certify that it has evaluated the above candidate for medical fitness for
enrollment as Home Guard Volunteer in the Directorate General of Home Guards Delhi , in pursuance
of the prescribed standards as per point 12 (page 5 & 6) of Standing order No. 15 for the Enrolment
of Home Guards Volunteers, General Duty in the Directorate General of Home Guards, Delhi, and
candidate’s personal declaration. On the basis of above evaluation, our opinion regarding the medical
fitness of the candidate for the above post is:
i) Fit
ii) Unfit on account of ___________________________________________
iii) Temporarily Unfit on account of __________________________________
Signatures:-
Medical Officer/Member Medical Officer/Member Chairperson Medical Board
Name, Designation with seal Name, Designation with seal Name, Designation with seal