Genl.

15

Revised fom according to Corrigenda No. 28 dated 17th September 1980

To the Karnataka Service Regulations (Act 32)

Physical Fitness Certificate

, do hercby certify that I have examined.Mxzidhax...Saal.Lankads.

SaxBanSels... a andidatefor.kengkt.uesk.
and that I cannot discover that he/she has any disease, constitutional affection or bodily

infirmity expect.. ***°******°*********°******************************* I do not consider this as

disqualification for employment in the office.Maxcual...afaxala...aka.ticans

****** Y ******°*******.o.**.ee....o. *.*****o*************************°

2. I am satisfied by personal examination from certificate produced by that he/she was

vaccinated / revaccinated within One week prior to the date of certificate.

3. Mx2xiadonx..nsl.Esstsaak. *****************
....is age is according

to his/her own Statement.. a .****.*. ..year and by appearance

about. 2 K.******************°*****..year.

4. Height. S"
J.********ero*

5. Weight.. .aa.kgs. so*osse*****ec******

6. Chest measurement on full inspiration.

1. Acuteness of vision.

a) Right Eye
b) LeftEye

Station:a slau Sigpure

Dae: 03/0s/2e12
 Genl. Genl. 15

Revised fom according to Corrigenda No. 28 dated 17th September 1980

To the Karnataka Service Regulations (Act 32)

Physical Fitness Certificate

L, do hepeby certify that 1have examined.M..can.tash..shia.Jedant.

àMaiacdast. * * * * * * * * .
aandidate for...aight.kaesk..
and that I cannot discover that he/she has any disease, constitutional affection or bodily

infimity expect.. ****°***° *** ***.** *****°**********°°°*****°

.. I do not consider this as

disqualification for employment in the ofice..Moxuek..Ata.a..olatiens

**** *°°° * * * * ° * ° * * * * ° ° ° ° ° * * ° ° ° * ° . *°°°*°°°

2 I am satisfied by personal examination from cetificate produced by that he/she was

vaccinated/ revaccinated within One week prior to the date of certificate.

3. Ma antis.h...hisal..Jadad. ..is age is according

to his / her own Statement... ..year and by appearance

about.. .year.

4. Height.
*********** *************°*°

5. Weight. ga. ****e**********************

6. Chest measurement on full inspiration.

7. Acuteness of vision.

a) Right Eyeq
Left Eye knv
b)

N Vh yopooy
Station: hr Sigpure

Date: 03/0s/2022