FORM `B` [See Rules 6(a)] Medical Fitness Certificate 1. Name: 2. Father's Name: 3. Age: 4. Height: 5. Residential Address: 6. Mark of identification: 7. Signature/Thumb impression: 8. X-Ray report ( of cough is of more than two weeks duration): 9. Stool and Urine report: 10. Whether immunized against Cholera and Typhoid with date: Date:......... Place:........ M.B.B.S MEDICAL OFFICER MGPPB-1/ Medical/2001 50,000 copies ST. PM5 n.
