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Sample Fitness for Duty Certification - State of Oregon ...

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Sample Fitness for Duty Certification - State of Oregon ...

DATE: TO: FROM: SUBJECT: Fitness for Duty Certification. Family and Medical Leave for your own serious health condition ends on (date) _____. Prior to returning to work you must provide a Fitness for Duty Certification verifying whether you are able to return to work, if you have any job-related ...

http://www.oregon.gov/DAS/CHRO/docs/advice/fmla/sample_fitness_cert.doc

Date added: January 22, 2013 - Views: 308

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Periodic Medical Fitness Certificate Format

Title: Periodic Medical Fitness Certificate Format Author: Ajay Kumar Last modified by: Cherry B. Kabiling Created Date: 1/25/2011 6:01:00 AM Company

http://www.almansoori.biz/uploads/HSEQ/Forms/F1111%20Lost%20Time%20Form%20Rev01%2025012011.doc

Date added: May 5, 2013 - Views: 227

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FORMAT OF

MEDICAL FITNESS CERTIFICATE. I certify that I have carefully examined Sh./Km ... medical test. Title: FORMAT OF Author: bfi Last modified by: Office Created Date: 4/15/2009 6:26:00 AM Other titles:

http://www.bfcet.com/doc/medical_fitness.doc

Date added: August 2, 2013 - Views: 122

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Periodic Medical Fitness Certificate Format

Title: Periodic Medical Fitness Certificate Format Author: Ajay Kumar Last modified by: huda Created Date: 12/10/2003 5:41:00 AM Company: Almansoori Specialized Engg

http://www.almansoori.biz/uploads/HSEQ/Forms/F593%20Vehicle%20Monitoring%20Device%20Analysis%20Report%2010122003.doc

Date added: May 5, 2013 - Views: 230

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Medical Form - Office of the Superintendents of Police, Karachi

Form of Medical Certificate in respect of an applicant for license to drive any transport vehicle or drive as a paid employee ... MEDICAL FITNESS CERTIFICATE. FORM B (To be filled up by a registered medical practitioner) Author: User Last modified by: Khurram Ali Created Date: 12/11/2007 10:16:00 AM

http://ccptraffickyc.pk/downloads/Medical-Fitness-Certificate.doc

Date added: February 6, 2012 - Views: 22

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DECK & ENGINEERING OFFICERS (STCW 95): - TIRM : THE ...

Medical Fitness Certificate -Panama format only * All Deck officers, Engineers and Gmdss Operator need to have their COC authenticated by the home-country. * Tanker Endorsement requirements: 1. Valid Panamanian License . 2. Copy valid Passport. 3.

http://www.tirm.me/Application-forms/Seafarer-Endorsement-General-Requirements.doc

Date added: December 31, 2013 - Views: 15

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FORM-I - Welcome to Rak Training Ship Sindbad

Medical Fitness Certificate for Sea Service( in original) in the prescribed format issued by DGS approved Medical Examiners. D. D. M M Y Y. Place of Issue Date of Issue Name of the Doctor No: 18. Category in which applied ...

http://merchantnavyeducation.com/uploadimage/4_Indian_CDC_Application_Form.doc

Date added: April 4, 2014 - Views: 7

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MEDICAL CERTIFICATE FOR LEAVE OR EXTENSION OF LEAVE OR ...

MEDICAL CERTIFICATE OF FITNESS TO RETURN TO DUTY. I, Dr. ……………………………………, ... MEDICAL CERTIFICATE FOR LEAVE OR EXTENSION OF LEAVE OR COMMUTATION OF LEAVE Author: ashok Last modified by: gurubramha Created Date:

http://www.whatvwant.com/wp-content/uploads/2014/06/medical_and_fittness_format.doc

Date added: June 28, 2014 - Views: 3

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JOB DESCRIPTION FORMAT

Same Format as designed in “Job Satisfaction” except. You will have to change the word. ... Medical Fitness Certificate. Mode of Travel/Conveyance. PF/ESI Particulars. Any more List (Pl. add) Checked by: Approved by: HR In-charge. To: Personnel File.

http://banyanhr.com/DOWNLOADS/HR%20ENCYCLOPEDIA/MISC%20FORMAT/MISC.FORMS.doc

Date added: December 27, 2012 - Views: 29

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www.sfitengg.org

Physical / Medical Fitness Certificate from a registered Medical Practitioner . 15. Certificate of Experience. 16. Transfer Certificate and Migration Certificate or Eligibility Certificate as applicable. 17. Copies of Papers published. 18.

http://www.sfitengg.org/ME%20Application%20form%20format.docx

Date added: June 6, 2013 - Views: 33

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SELECTION OF CANDITATES FOR PG CERTIFICATE COURSES

Attestation complete with photographs in triplicate (Format enclosed) v) Degree Certificate(s) ... Medical Fitness Certificate from a Civil Surgeon. viii) Caste Certificate for OBC/SC/ST candidates to be submitted in the . enclosed format prescribed by the Govt. of India. i x) ...

http://www.aipnpc.com/Terms-Conditions.doc

Date added: August 3, 2013 - Views: 10

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Prescribed Medical Standards for Admission

CERTIFICATE OF MEDICAL FITNESS. To be obtained only from a Gazetted Government Medical Officer/ Medical Officer of a Government Undertaking. Please note that this certificate in no other form will be accepted.

http://www.tcsion.com/EForms/html/form50/medical%20fitness%20format.docx

Date added: June 1, 2014 - Views: 2

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Dr

Medical Fitness Certificate (From Center/State Govt.Hospital/Dispensary). Affidavit in prescribed proforma in case of GAP in studies. Following . documents . ... Category Certificate (For OBC/SC/ST/PH) - as per CSAB 2014 Format. Verifying Officer. F.

http://www.nitj.ac.in/News/Admissions2014/reportingperforma.docx

Date added: August 4, 2014 - Views: 1

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APPLICATION FORM - Euro Tech Maritime

CONTINUOUS DISCHARGE CERTIFICATE-CUM-SEAFARER’S IDENTITY DOCUMENT (CDC) ... 18. Medical Fitness Certificate for Sea Service( in original) as prescribed in Annexure “E” ... format are liable to be rejected. 6.

http://www.eurotechmaritime.org/images/mainimages/CDCForm.doc

Date added: July 10, 2013 - Views: 18

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Requirement for Revalidation of Masters & Deck Officers of ...

Medical fitness certificate as per M.S. (Medical Examination ) Rules, 2000. 3. 10 days Revalidation course certificate for Master & Deck Officers in prescribed format as per M.S. Notice No. 13 of 2003 4. Approved sea going service, performing functions appropriate to the ...

http://www.mmd.gov.in/requirement_revalidation.doc

Date added: April 19, 2012 - Views: 14

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Note: letters have already been issued, in case non receipt ...

Medical Fitness Certificate in the prescribed format enclosed. Annexure-I. SC/ST/PHP Certificate, if applicable (PHP candidate should submit his / her caste and disability certificate issued by the Medical Board attached with the Vocational Rehabilitation Centre ...

http://www.nift.ac.in/downloads/waitlisted_BFTech/necessary_annexure.doc

Date added: August 3, 2013 - Views: 1

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LIST OF TECHNICAL STANDARDS: - SourceForge

Format for personal medical fitness certificate FCL 62-7. 2. Format for Medical Practioner’s declaration FCL 62-8. 3. ... A medical fitness certificate to be submitted by the applicant for or the holder of a recreational pilot licence in terms of sub-regulation 62.01.10 (2) ...

http://stpxml.sourceforge.net/skygod/Airlaw/Part62-2006/SA-CATS-FCL-62CAA.doc

Date added: May 2, 2013 - Views: 23

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www.mimsmandya.org

5.Medical Fitness Certificate. 6.Pass Certificate of XIIth Std. 7. Residential Proof. 8. CET Card. 9. Study Certificate DECLARATION. I undertake to attend not less than ¾ of the number of periods in each of the subject comprised and in contrary; I shall not be eligible to appear for the ...

http://www.mimsmandya.org/MBBS-2014/1-MBBS_Admission_Format.doc

Date added: August 17, 2014 - Views: 1

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1)

I am not suffering from any chronic disease and I have attached the medical fitness certificate from aqualified chief medical officer. The particulars given above are true to the best of my knowledge and nothing has been concealed.

http://iitmedu.in/pdf/IITM%20Admission%20Form.doc

Date added: August 3, 2013 - Views: 9

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RECRUITMENT POLICY - HR Expert Help

To bring in more dynamism and effectiveness in the recruitment process, ... Medical Fitness Certificate (in specified format) signed by a Medical Practitioner registered under IMA.

http://hrhelp.files.wordpress.com/2007/07/recruitment_policy1_1541.doc

Date added: October 10, 2011 - Views: 94

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Medical Reports and Certificates

Medical Certificate of Stillbirth 34, FW8, FP92A. In addition, other certificates which have no specified format, or no reference number: To establish pregnancy for the purpose of obtaining welfare foods. To establish fitness to receive inhalational analgesia in childbirth.

http://brotaflmc.org.uk.c31.sitepreviewer.com/ESW/Files/Medical_Reports_and_Certificates_-_general_considerations.doc

Date added: May 26, 2013 - Views: 9

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ACHARYA SHRI CHANDER COLLEGE OF MEDICAL SCIENCES & HOSPITAL

FORMAT OF UNDERTAKING LETTER FOR NRI PARENT/GUARDIAN (MBBS) (Attested by legal authority) ... Medical fitness certificate (at the time of joining college) Transcript from abroad student. Provisional certificate (If applicable) Migration certificate .

http://ascomscollege.com/Notices/NRI_MBBS_Forms_2011_Aug.doc

Date added: April 8, 2012 - Views: 51

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Shri - DKMM Homoeopathic Medical College

D.K.M.M. Homoeopathic Medical. College & Hospital ... Nationality Certificate / Xerox of Valid Passport Entrance Test ... Medical Fitness Certificate Undertaking for not having taken admission to PG course in last 3 years as per format Affidavit for Change in Name ...

http://dkmmhomoeocollege.com/wp-content/uploads/2013/08/M.D.regular-Admission-form-2014-15.doc

Date added: August 5, 2014 - Views: 1

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www.nift.ac.in

Medical Fitness Certificate in the prescribed format. .Annexure- I . An undertaking in the prescribed format Annexure- II. In case any Certificate submitted by you is found to be of false or not conforming to the stipulated standards mentioned in the Admission Guidelines, ...

http://www.nift.ac.in/downloads/form_and_undertaking_for_NRI_&_ward_of_NRI.doc

Date added: July 4, 2013 - Views: 6

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2. Physical Fitness Verification -- Proforma for Health Check-Up

Annexure-I . CERTIFICATE OF PHYSICAL FITNESS (To be filled by a Registered Medical Practitioner . in the applicant’s country of domicile) Name of Applicant _____

http://www.iccrindia.net/students/physicalfitnessverification-format-2014-15.doc

Date added: December 13, 2013 - Views: 6

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WALK – IN – INTERVIEW FOR THE POST OF

Selected Candidates will have to execute contract / agreement in the prescribed format of the department. ... You have to produce a medical fitness certificate from the authorized/ Govt. Medical Officer at the time of joining.

http://bnpdewas.spmcil.com/SPMCIL/UploadDocument/WALK%20IN%20INTERVIEW%20FOR%20THE%20POST%20OF%20MEDICAL%20OFFICER.ea0c095e-df26-4ca9-ada0-fce3b9272375.22af9ba1-34cf-490b-9889-c010523fed14.doc

Date added: September 11, 2014 - Views: 1

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www.springdaleindia.com

Please note that the Medical Fitness Certificate has to be in the ILO147 format from a DG Shipping approved doctor. You may contact your shipping company doctor for the same.

http://www.springdaleindia.com/files/Class_I_NOE_Guidance_Procedures_-_Copy.docx

Date added: September 11, 2014 - Views: 1

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www.mngssl.org

CERTIFICATE OF ENDORSEMENT Mongolia Ship Registry Pte Ltd. ... format – JPEG only. file size – not exceeding 200 KB. resolution – 300 pixels per inch. Copy of a valid STCW-95 Certificate of Competency with Endorsement; Copy of a valid Medical Fitness Certificate.

http://www.mngssl.org/documents/formCOE.doc

Date added: August 27, 2014 - Views: 1

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INFORMATION IN CONNECTION WITH ADMISSION TO DIPLOMA COURSES

Note : The domicile certificate by choice or domicile certificate for educational purpose shall not be considered. Reservation of Seats : These rules are subject to change as per Government of Maharashtra directives. Reservation for Backward Classes :

http://www.raisoni.net/raisoniad/Teqipfile/Admission_details_012909060236.doc

Date added: September 4, 2014 - Views: 1

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www.arunachalgovernor.nic.in

Note: Please submit with two passport photographs, medical fitness certificate along with this form to Director, Youth and Sport Affairs, Chimpu on or before 10th May 2009. Mobile No.09436634938. Author: Charlie Last modified by: Charlie Created Date:

http://www.arunachalgovernor.nic.in/doc/format_for_Golf_orientation_camp.doc

Date added: August 27, 2014 - Views: 1

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Sub- Aqua Expedition Organization and Conduct – Outcome of ...

No other diving medical in whatever format is valid – no Annex 8C, no dive. c. ... A valid Annex 8C Medical Certificate of Fitness to Undertake Service Sports Diving Under Joint Service Sub-Aqua Club and British Sub-Aqua Club Regulations’.

http://www.raf.mod.uk/rafsubaqua/rafcms/mediafiles/BD812C72_5056_A30A_091163A8827C384E.doc

Date added: August 3, 2013 - Views: 2

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Arpc Form 4109 - U.S. Army HRC Family

DA Form 7349, Initial Medical Review (complete Part I, blocks 1-13b) and SF 507, Functional Capacity Certificate. DA Form 705, Army Physical Fitness Test Scorecard. DA Form 5500, Body Fat Content Worksheet (Male) or DA Form 5501, ...

https://www.hrc.army.mil/site/Reserve/download/forms/ahrc4109.dot

Date added: November 5, 2011 - Views: 45

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DISTRICT HEALTH & FAMILY WELFARE SAMITI, HOOGHLY

FORMAT FOR EXPRESSION OF INTEREST FOR EMPANELMENT OF MATRI YAAN CHARGES For Commercial Registered AMBULANCE / VEHICLE . To. ... Photocopy of the registration certificate (bluebook) with valid fitness certificate. ... Chief Medical Officer of Health, & Secretary, Health & Family Welfare Samiti ...

http://www.hooghlyhealth.com/wp-content/uploads/2012/02/Matri-Yaan-Format.doc

Date added: November 5, 2013 - Views: 2

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Safe Manning Proposal Format - AMSA :: Australian Maritime ...

• Marine Order 9 (Health – medical fitness) 2010, details requirements for medical fitness and certificate ... chapter 2 of the Navigation Act 2012 prescribes that it is an offence to take a vessel to sea without proper medical supplies. Owners of Australian ... Safe Manning Proposal Format ...

http://www.amsa.gov.au/forms-and-publications/AMSA423.dot

Date added: July 4, 2013 - Views: 10

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HSE Specification - Public Health

1.8 Reporting Format. New Section added. 2.3.6 HACCP ... All food handlers must possess a current Medical Fitness Certificate issued by a recognised ... The PDO Cooperate Public Health Adviser shall have the right to review Medical Fitness Certificates and to stop the work of any employee who ...

http://www.pdo.co.om/hsems/Documents/Specifications/SP-1232%20-%20HSE%20Specification%20-%20Public%20Health.doc

Date added: July 29, 2013 - Views: 7

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Laurin Maritime AB - NAUTA

Expiry Date Medical fitness certificate Drug and Alcohol test Vaccination for yellow fever 5. Other data. English Language Skills Other Foreign Languages Skills 6. Sea Service (Please use European date format DD.MM.YY.) Vessel Company Flag Type DWT. Main engine/HP ...

http://nauta.com.ua/uploads/user/Nauta%20application%20form.doc

Date added: November 5, 2013 - Views: 6

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www.vesit.edu

Medical Fitness Certificate . CET Mark Sheet. Sindhi Minority Affidavit (as per format given below) Nationality Certificate. Domicile Certificate. Community Certificate* (if required) If CBSE Board or ICSE Board 12th Std. Passed :-

http://www.vesit.edu/eligibility.doc

Date added: August 31, 2014 - Views: 1

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www.ipu.ac.in

The officer/official after he/she joins, will submit the application on the prescribed form-I alongwith the Medical Fitness Certificate, and get the leave due verification done from the Establishment Branch, ... (Estt.) about the admissibility of leave on the format.

http://www.ipu.ac.in/establish/sop.DOC

Date added: February 29, 2012 - Views: 19

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Download - St. Vincent & the Grenadines - St Vincent Flag

... a valid medical fitness certificate, a valid passport, ... Certificate of Competence. STCW Endorsement . Seaman’s book . Passport . Medical Certificate. issued on: Recent scanned photo (JPG format) Basic Safety Training & Instructions (VI/1)

http://www.svg-marad.com/Downloads/Forms/STCW%2095%20Application/Application%20for%20Seaman%27s%20Documents.doc

Date added: May 24, 2013 - Views: 11

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www.mngssl.org

format – JPEG only. file size – not exceeding 200 KB. resolution – 300 pixels per inch. Copy of a valid STCW-95 Certificate of Competency with Endorsement; ... Copy of a valid Medical Fitness Certificate. Page 1 of 1. Created Date:

http://www.mngssl.org/documents/formGOC.doc

Date added: December 13, 2013 - Views: 2

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Safe Manning Proposal Format - AMSA :: Australian Maritime ...

Medical certification (Regulation 1.2) • Marine Order 9 – Health – Medical fitness, 2013 details requirements fitness and certificate requirements for seafarers. 3. Qualifications of Seafarers ... Safe Manning Proposal Format ...

http://www.amsa.gov.au/forms-and-publications/AMSA420.dot

Date added: July 4, 2013 - Views: 14

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INSTRUCTIONS FOR CANDIDATES, BATCH – 2010-2011 - .:NTS™:.

Selected Candidates for admission in Bachelor of Technology (Pass / Hons), First Year class, ... format is given on Appendix V, Hafiz-e-Quran Certificate from Wafaq-ul-Madaris, in original ... Medical Fitness Certificate in original on the proforma prescribed on page No. 123, ...

http://www.nts.org.pk/NTSWEB/STEVTA_24Oct2010_2ndMerit/instructions.doc

Date added: January 27, 2012 - Views: 7

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APPLICATION FORMAT

1 Medical Officer 1 UR 25000/- pm 40. ... please write category to which you belong and attach a copy of Certificate in the prescribed format issued by Competent ... I am not aware of any circumstances, which might impair my fitness for employment under Government. Signature of candidate. Date ...

http://www.hil.gov.in/(S(yafqgvvn51he24fgmwv1df45))/writereaddata/Medical%20Officer%20Advt3.doc

Date added: June 1, 2013 - Views: 8

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JOB A: (SCOPE OF WORK)

BOM format is given at Appendix-1. This scope of work forms part of the work order. 2 System Design & Operation Philosophy: ... The personnel to be deployed to offshore should have a valid medical fitness certificate from MMD approved doctor.

http://xa.yimg.com/kq/groups/13724245/88387554/name/Barge+Instrumentation+Sysytem+for++Jank+Up+Rig+Sagar+Jyoti+26June09.doc

Date added: May 2, 2013 - Views: 15

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Front Page - Acharaya Shri Chander

MBBS degree certificate obtained by the applicant from a University, ... 8.4 Candidates selected for admission in the College will be required to produce a Medical Fitness Certificate issued by a qualified Doctor ... FORMAT OF UNDERTAKING LETTER FOR NRI/NRI’s WARD POSTGRADUATE MD/MS COURSES

http://ascomscollege.com/Notices/2014/InfoBrochureMD-MS2015.doc

Date added: March 1, 2014 - Views: 3

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vesit.edu

Sindhi Minority Affidavit with Notary (as per format given in website) Certificate from Sindhi Community Association/Panchayat. Medical Fitness Certificate by Registered Practitioner. Required Documents .

http://vesit.edu/admission2013/FE2013-14/Eligibility%20criteria_13_14_for%20students.docx

Date added: June 22, 2013 - Views: 5

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Circular IT 02 / 05 - Arrangement for partial resumption of ...

At the end of this period it is to be expected that the lecturer shall have reached a state of medical fitness ... 3.2 A medical certificate from the medical ... Arrangement for partial resumption of duty by a lecturer in Cases of Serious illness/major surgery (file Format Word ...

http://www.education.ie/en/Circulars-and-Forms/Active-Circulars/it02_05.doc

Date added: May 2, 2013 - Views: 11

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www.annauniv.edu

FORMAT FOR LETTER FROM EMBASSY (In the Letter head of the Embassy office) No ... Candidates have to submit a medical fitness certificate at the time of final allotment as per Annexure-I. 2. GENERAL INFORMATION. 2.1. Reporting to the University:

http://www.annauniv.edu/cia/forms/pgnri.doc

Date added: May 18, 2013 - Views: 8

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F

Therefore interested candidates with in the age limit 17 to 25 years as on 1st Jan 2008 may apply in prescribed format along with 10th Standard Pass Mark sheet , proof of date of Birth and Medical Fitness Certificate.

http://lakshadweep.nic.in/CircularGPAgeRelax.doc

Date added: January 18, 2014 - Views: 1

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Tele : “JIPMER”

JAWAHARLAL INSTITUTE OF POST GRADUATE MEDICAL EDUCATION & RESEARCH ... names/particulars of two referees from your speciality who are in a position to testify from personal knowledge to your fitness for the ... Registration with Medical Council Certificate 9. Any other relevant ...

http://jipmer.edu.in/wp-content/uploads/2014/02/Application-Format-for-faculty-posts-updated.doc

Date added: March 1, 2014 - Views: 6