Certificate of Fitness for Employment

(To be issued by a Certified Medical Practitioner Only)

!. Name of the Person Examined ________________ _________________ ______________

First Name Middle Name Surname

2. Sex MALE / FEMALE

3. Date of Birth ________________________

4. Position offered by Company _________________________________________________

I certify that I have personally examined the above person on dated _________________ whose
identification marks are _____________________________________________ and who is
desirous of being employed in the Company named NETAFIM IRRIGATION INDIA PVT.
LTD. His / Her Age, as nearly as can be ascertained from my examination is ___________ yrs.

I have also examined all the pathological tests and X-rays reports submitted to me and on the
basis of my over all medical check up of the above named person I declare that in my opinion
he / she is Fit / Unfit for the employment as offered above.

_____________________________ ______________________________
Signature of the Doctor with Seal Signature of the Person Examined

Name : ___________________________

Registration No. : ___________________________

Address : ___________________________

__________________________________________