Thanks to visit codestin.com
Credit goes to www.scribd.com

Scribd
Upload
8K views1 page

Medical Fitness Certificate For Swimming To Whom So Ever It May Concern

This medical certificate determines if an individual is medically fit to swim. It lists common medical conditions and asks if the patient suffers from allergies, asthma, heart issues, diabetes, hypertension, seizures, muscle cramps, physical or mental disabilities, or any other major diseases. The doctor examines the patient and declares whether they are medically fit to swim and free of serious medical disorders, signing and dating the certificate. The certificate is only valid if issued by a qualified medical practitioner with the proper degree for the patient's age.

Uploaded by

Bhavik Samariya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
8K views1 page

Medical Fitness Certificate For Swimming To Whom So Ever It May Concern

This medical certificate determines if an individual is medically fit to swim. It lists common medical conditions and asks if the patient suffers from allergies, asthma, heart issues, diabetes, hypertension, seizures, muscle cramps, physical or mental disabilities, or any other major diseases. The doctor examines the patient and declares whether they are medically fit to swim and free of serious medical disorders, signing and dating the certificate. The certificate is only valid if issued by a qualified medical practitioner with the proper degree for the patient's age.

Uploaded by

Bhavik Samariya
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

MEDICAL FITNESS CERTIFICATE FOR SWIMMING

To whom so ever it may concern

Stick Your Photo


Here
(તમારો ફોટો અહીં
ચોંટાડો.)
Membership Number:-............................................................................

This is to certify that I have examined Mr./Miss. ......................................................................................................

He/She is suffering / not sufferning from following diseases...

1. Any Allergy : Yes / No

2. Asthma or other chest problem : Yes / No

3. Heart Attack : Yes / No

4. Heart Failure : Yes / No

5. Diabetes : Yes / No

6. Hypertension : Yes / No

7. Seizures (Fits) : Yes / No

8. Prone to muscular cramps : Yes / No

9. Physically Disabled : Yes / No

10. Mental Disability : Yes / No

11. Any other major disease? : ....................................................................................................................


(Please specify)

Summarizing,
Is he/she medically fit to swim? : Yes / No

I, Dr. ..................................................., hereby declare Mr./Mrs./Ms. ..........................................................................


to be medically fit to swim, and that he/she does not posses a history of any serious medical disorders.

Signature of Medical Officer : ................................................


Date:- ....................... Doctor's Registration No. : ...........................................
Seal

Note:- For Under 50 years, Medical certificate granted by a qualified medical practitioner holding at least
M.B.B.S. Degree/ M.D. Degree OR For 50 years and above, Medical certificate granted by a qualified medical
practitioner holding M.D. Degree and registered with Medical Council of India, shall only be valid.

You might also like