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Proforma

for Medical Certificate to be obtained from an Eye Specialist by candidates applying for the post of Assistant Station Master I Traffic Assistant

I have checked up Shri/Smt._________________________________________ who has applied for the post of Assistant Station Master / Traffic Assistant* in Railways. The Acuity of Vision / Colour Vision of Shri/Smt.__________________________ has been tested in view of the following standards required for appointment on the Railways.

Signature of the Candidate

Post Assistant Station Master / Traffic Assistant*

Medical Standard A2

Distant Vision

Colour Vision on Ishihara 6/9, 6/9 without glasses Sn 0.6, 0.6 Normal with Fogging Test without glasses

Near Vision

Shri/Smt. ________________________________________ fully conforms to the above Vision standards as applicable for the post of Assistant station Master / Traffic Assistant*. (*Please delete which is not applicable) Signature of the Eye Specialist: __________________________ Place: Name of the Eye Specialist: ______________________________ Date: Registration No.: __________________________________________ Seal of the Eye Specialist

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