Certificate medical re-examination by Appellate Medical Board

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.... 1. any employment in mine. 2. any employment belowground. 3. any employment in work. .......... (Specify in details)   After re-examination, we consider that - 1. Employee is medically fit for any employment in mine. 2. Employee is suffering from ............. and is medically unfit for (a) any employment in mine. (....

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....port of the Appellate Medical Board Annexure to certificate No ...............as result of Medical examination on . ............... Identification mark : Left thumb impression & Signature of the candidate 1. General development-             Good/Fair/Poor 2. Height. .............. Cms. 3. Weight. ...............kg. 4. Eyes....

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....ion Test (Spirometry) if required Parameters Predicted Value Performed Value % of Predicted Forced Vital Capacity (FVC)       Forced Vital Capacity 1 FEV1       FEV1/FVC       Peak Expiratory Flow       Spirometry Report enclosed 7. Circulatory system: Blood Pressure :- ....

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....in: Sugar: 16. Pathological Investigations: S.No. Tests Findings 1 Blood-Tc,Dc,Hb,ESR, Platelets WNL/Abnormal 2 Blood Sugar- Fasting & PP WNL/Abnormal 3 HbA1c if required WNL/Abnormal 4 Lipid profile WNL/Abnormal 5 Blood Urea, Creatinine WNL/Abnormal 6 Urine Routine WNL/Abnormal 7. Hemoglobin Electrophoresis (if required) ....