To
The Medical Superintendant, Dr. RML Hospital, New Delhi.
The Medical Superintendant, Safdarjang Hospital, New Delhi.
The Medical Superintendant, All India Institute of Medical Sciences
(AIIMS), Ansari Nagar, New Delhi.
Subject:- Issue of Medical/disability certificate for allotment of Govt. accommodation – Regarding.
Sir/Madam,
No. Date
1) General Observations:
2) Specific recommendations:
(i) Detailed description of illness/disability alongwith investigations, if any:
(ii) Is the disability permanent or likely to improve with time.
(iii) Class/stage of disease/percentage/grade of functional disability in spite of optimum treatment and intervention.
(iv) Is the ailment/disability serious enough to be considered for allotment or change of Govt. Accommodation at any / Ground Floor on overrding priority:
Alongwith Attested Photograph}
Note:- Physical disability certificate issued by single doctor in pursuance of Guidelines No. S-13020/ 1/2010-MS/MH-II of Directorate General of Health Services (Medical Hospital Section-II), Nirman Bhawan, dated 18.6.2010 is also acceptable.
Signatures of Members of Board alongwith rubber-stamp/date:
(Member) (Member) (Member)
(Seal with Name) (Seal with Name) (Seal with Name)
Source: Click here to download Proforma
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