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Est. 95

.Mahanagar Telephone Nigam Limited Mumbai

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Signature of Applicant

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. Medical Certificate for non-gazetted officer recommended for leave or extension or
commutation of leave
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(A Govt. of India Finance Departmeht, No, 173-S. R. dated 16 March, 1931)

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I. after careful examination of the case hereby certify that
.................................................... whose signature is given above is suffering from and
is considered that a period of absence from duty of with effect from is
absolutely necessary for the restoration of his health.

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Govt. Medical Attendent
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or
Date : . Registered Practitioner (No.

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Medical Certificate of fitness to return to duty

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Signature of Applicant

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Civil Surgeop
I. :.... do certify that' have carefully
Registered Medical practitioner of
examined of the Department. : whose
signature is given above. He has recovered from his illness and is now fit to resume his duties in Government
Service. I also certify that before arriving at this decision I have examined the original medical certificate and statement
of the case (or certified copies thereof) on which leave was granted or extended and have taken these into consideration
in arriving at my decision.

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Govt. Medical Attendent
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