APPENDIX-I (Referred to in Para-IV) (To be supplied by the candidate who have been actually selected for admission) FORM FOR MEDICAL CERTIFICATE I certify that I have carefully examined Mr./Ms.____________________________ Son/daughter of ___________________________ that his/her age is about ____ ___________________________ that he/she is of the required Physical standard as prescribed in Appendix II. Un-expanded Inches His/Her chest measurement is ____________________________________ Expanded Inches Does not wear Glasses His/Her eye sight is up to the prescribed standard ______________________ Does wear. Glasses Details of glasses if worn, He/She has no disease or mental or bodily infirmity unfitting him/her or likely to unfit in the future for ______________________________________ active out door service. Mark of Identification Thumb -Impression Dated the _______________ Medical Officer Note: This form must be retained by the candidate as he/she will be required to bring it with him/her when called for medical examination. The photograph is to be attested by the medical officer. Photograph to be attested by Medical officer APPENDIX-II (Referred to in Para-IV) PHYSICAL AND EYE-SIGHT STANDARD FOR ADMISSION TO GOVERNMENT DIPLOMA INSTITUTION i. To be passed it for admission to the _________________________ a candidate must be of good mental and Physical health and free from any physical defect likely to interfere with the efficient performance of duties in Govt. service. ii. Chest expansion shall not be less than 1 ½ inches. The candidate's chest shall be measured as follows:- He/She will be made to stand erect with his/her feet together and to raise his/her arms over his head. The tape will be so adjusted the chest that its upper edge touches the interior angles of the shoulder blades behind and its lower part of the nipple in front. The arms will than be lowered to hand loosely by the side and care will be taken that the shoulders are not thrown un-ward so as to displace the tape. The candidate will then be directed to take a deep inspiration several times when the maximum expansion of the chest will be carefully noted and the measurement recorded. iii. Acuteness of the vision will be ascertained by two tests (one from distance and the other from near vision). The test for distance vision with or without glasses will be at 20 feet. The test for the near vision will be at any distance selected by the candidates. The standard for visual acuity with or without glasses shall be:- Better eye Worse eye Distance vision 6/9 or 6/6 6/9 or 6/12 Near Vision 0.6 0.8 iv. The total amount of Myopia (including the cylinder) shall not exceed 600 D.total amount of hypermetropia including the cylinder shall not exceed 600D. Glasses allowed for hypermetropia or hypermetrople astigmatism shall not exceed 3.5 D Glasses allowed for myopia or myopia astigmatism shall not exceed 2.5 D. v. Color Blindness:- A candidate is disqualified if he be unable to distinguish principal colors(Archro atopsia) vi. Squint or any morbid condition subject to the risk of aggravation or recurrence in either eye disqualifies a candidate for service. vii. The following additional Points will also be observed:- a) That his hearing is good and there is no sign of ear disease. b) That his speech is without any impediment. c) That his teeth are in good order. He must have 10 sound teeth in the upper Jaw junctionally opposed to 10 sound teeth in lower jaw two of these teeth in each jaw must be molar. Well filled teeth will be considered as sound. d) That his chest is well formed and that his lungs are sound. e) That he is not ruptured. f) That he does not suffer from a severe degree of varicose of varicocle veins. A candidate who has been successfully operated on will be accepted. g) That his limbs are well formed and developed. h) That there is free and perfect motion of all joints. i) That his feet and toes are well formed. j) That he does not suffer from any inverterate skin in disease. k) That he has no congenital malformation or defect. l) That he does not bear traces of previous acute or chronic disease pointing to an impaired constitution.
