N.I. CARD NO.
_________________________________________
MEDICAL CERTIFICATE OF FITNESS ON 1ST ENTRY INTO GOVERNMENT SERVICE REFERRED TO RULE
( C.S.R. [Link]).
I hereby certify that I have examined _______________________________ a candidate for Employment in
the ___________________ department and cannot discover that he/she any disease constitutional affection or
bodily infirmity except _______________. It does not consider this a disqualification for employment as
__________________. His / Her age according to his/her own statement is _______________________ and by
appearance he/she is about _________________ years. The candidate _________________________________.
Or has been re-vaccinated within the last 12-month or
already had small-pos and show obvious scars there. ``
Left/right thumb and finer impression.
FORTH OR SMALL THIRD FINGER SECOND FINGER FIRST FINGER THUMB
Taken before ______________________________________
On date ______________________________________
Name of Official ______________________________________
Religion Profession ______________________________________
Residence _____________________________________________________________________
______________________________________________________________________________
Father’s Name ________________________________
Date of birth Christian year as nearly as can be ascertained
________________________________
Exact height by measurement __________________________
Identification marks: - Picture
1._____________________________________________
2._____________________________________________
MEDICAL SUPERINTENDENT
D.H.Q. HOSPITAL JHANG
I do hereby declare that I have not already at any time been pronounced unfit Government
Service by the Medical Board of embassies Pakistan or any other constituted medical authority.
Signature of candidate ______________________