Medical Certificate To Prove Age

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MEDICAL CERTIFICATE TO PROVE AGE
(To be signed by a registered medical practitioner holding a degree not below that of M.B.B.S.)
……………………………………………………..
Signature/Thumb(Left) impression of applicant
I Dr.________________________________________________________________
_____________________________________________________do hereby certify that I
have examined Shri/Smt.________________________________________________
_________________________________________________________________whose
signature /Left thumb impression is given above, and found that his /her age according to
his/her own statement is ________years and by appearance about ______years.
This certificate is issued to be produced at ______________________________________
for_______________________________________________________________
Place:
Date:
Signature of the Medical Officer
Time:
Name:
Designation:
* Strike whichever is not applicable.

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