Certified that I/We have carefully examined Shri/Shrimati son daughter of Shri in the Department/ Office. His/Her age by his/her own statement is Years, and by appearance about Years. I/We connsider Shri/Shrimati to be completely and permanently incapacitated for further service of any kind in the Department/ Office to which he/she belongs in consequence of there state disease or cause. Government of Orissa Department of Public Grievances & Pension Administration O.C.S.(PENSION) FORM 2 FORM OF MEDICAL CERTIFICATE [(See Note (3) below sub-rule (2) of rule 39] (If the incapacity does not appear to be complete and permanent, the certificate should be modified accordingly and the following addition should be made). "I am/We are of opinion that Shri/ Shrimati is fit for further service of a less laborious character than that which he had been doing/my, after resting for months,be fit for further service of less laborious character than that which he had been doing." Place: Signature of the Medical Authority Date: Published on National Portal of India (india.gov.in)
