2022 07 CCSE4 g4 Eng
2022 07 CCSE4 g4 Eng
Warning
All recruitments by the Tamil Nadu Public Service Commission are purely merit
based.
The Tamil Nadu Public Service Commission hereby cautions the applicants
against touts and agents who may cheat, by making false promises of securing
jobs through unfair means.
The Tamil Nadu Public Service Commission shall not be responsible or liable for
any loss that may be caused to any applicants on account of indulging in any sort
of dealings with such unscrupulous elements.
Applicants are solely responsible for their claims in the online application. They
cannot blame service providers like internet cafes/browsing centres/Common
Service centres for the mistakes made while applying online for recruitment.
Applicants are advised to check the filled in online application before finally
submitting the same.
ஓ ்ஓஞி்க
2. DETAILS OF VACANCIES
TABLE-A
VAO & Group-IV
TABLE-B
Posts in various Boards included as per Tamil Nadu Public Service Commission
(Additional Functions) Act, 2022 (Act No. 14 of 2022)
Note :
(i) *Vacancies shown here are the vacancies after deducting 3% of vacancies for
the reservation for meritorious sportspersons as per G.O.(Ms).No.6, Youth
Welfare and Sports Development (S1) Department, Dated 20.02.2019
(iii) The Carried forward vacancies details for the above said posts will be added
before the start of the Counselling process.
(iv) First, the selection will be made for the carried forward vacancies [Section 27
of the Tamil Nadu Government Servants (Conditions of Service) Act, 2016]
(v) Secondly, the selection will be made for regular vacancies following the rule
of reservation of appointments.
4
3. DISTRIBUTION OF VACANCIES
Note :
(i) The distribution of vacancies will be, subject to the outcome of final orders of
the Hon‟ble Supreme Court of India on the Special Leave to Appeal [SLP]
filed by the Government of Tamil Nadu with regard to the Tamil Nadu Act 8
of 2021.
(ii) Information regarding MBC(V), MBC-DNC and other MBC will be obtained in
the online application pending outcome of the above said Special Leave
Petition before the Hon‟ble Supreme Court of India.
Note:
5. QUALIFICATIONS
**As per G.O (Ms). No.91, Human Resources Management (S) Department, dated
13.09.2021, the Maximum Age Limit prescribed for appointment by direct
recruitment has been enhanced by 2 years.
Note:
(i) “Others” [i.e., Applicants not belonging to SCs, SC(A)s, STs, MBCs/DCs,
BC(OBCM)s and BCMs] who have put in 5 years and more of service in the
State / Central Government are not eligible to apply even if they are within
the age limit.
[For further details refer Para 3(F) of “Instructions to Applicants‟ and
Section 3(r) of the Tamil Nadu Government Servants (Conditions of
Service) Act, 2016]
(ii) Instructions given with regard to maximum age limit under Para 5A of the
“Instructions to Applicants” will not apply to the post of Village
Administrative Officer.
**As per G.O (Ms). No.91, Human Resources Management (S) Department, dated
13.09.2021, the Maximum Age Limit prescribed for appointment by direct
recruitment has been enhanced by 2 years.
6
Note:
(i) “Others” [i.e., Applicants not belonging to SCs, SC(A)s, STs, MBCs/DCs,
BC(OBCM)s and BCMs] who have put in 5 years and more of service in
the State / Central Government are not eligible to apply even if they are
within the age limit. [For further details refer Para 3(F) of “Instructions to
Applicants‟ and Section 3(r) of the Tamil Nadu Government Servants
(Conditions of Service) Act, 2016]
(ii) No maximum age limit for applicants belonging to SCs, SC(A)s, STs,
MBCs/DCs, BC(OBCM)s, BCMs and Destitute Widows of all castes
who possess a General Educational Qualification which is higher than the
Minimum General Educational Qualification (i.e. who have passed
P.U.C/H.S.C/Diploma/Degree).
Explanation:
“No maximum age limit” shall mean that the applicants should not have
completed 60 years of age either on the date of Notification or at the time
of selection/appointment to the post.
Persons with Benchmark Disability are eligible for age concession upto
10 years over and above the maximum age limit prescribed above.
[Section 64 of the Tamil Nadu Government Servants (Conditions of
Service) Act, 2016 and as per Para 5D of “Instructions to Applicants”]
(a) The maximum age limit is 55 Years for the applicants who belong to
SCs, SC(A)s, STs, MBCs/DCs, BC(OBCM)s and BCMs.
(b) The maximum age limit is 50 years for “Others” (i.e.) Applicants not
belonging to any of the above said categories.
[Section 63 of the Tamil Nadu Government Servants (Conditions
of Service) Act, 2016 and as per G.O (Ms). No.91, Human Resources
Management (S) department, dated 13.09.2021] [Refer Para 5B of
“Instructions to Applicants”]
(c) The above mentioned age concession will not apply to the Ex-
Servicemen applicants who have already been recruited to any class
or service or category.
[Section 3(j) of the Tamil Nadu Government Servants (Conditions of
Service) Act, 2016]
Note:
“Intermediate Grade in Shorthand is not
equivalent to Senior Grade.”
Note:
1. Those who have not passed SSLC Examination or its equivalent are not
eligible even if they possess a higher qualification.
Important Note:
Note:
(i) Every person appointed to the post shall pay a Cash Security of
Rs.2000/- (Rupees Two thousand only) within a period of one month
from the date on which he/she joins duty.
(ii) Provided that a person belonging to MBCs/DCs, BC(OBCM)s and BCMs
shall pay a cash security of Rs. 1000/- (Rupees One thousand only)
within a period of one month from the date on which he/she joins duty.
(iii) Provided further that a person belonging to SCs, SC(A)s and STs shall
not pay cash security.
(Failure to pay cash security as stated above shall render a person liable to
be discharged from service).
Every person appointed to the post of VAO shall reside in the Village under
his charge and shall continue to reside in the said Village as long as he/she is
in-charge of that Village.
(H) CASH SECURITY (for the Posts of Junior Assistant (Security), Bill
Collector Grade-I , Bill Collector and Store Keeper)
6. (A) FEES
a) Registration Fee
For One Time Registration [G.O.(Ms).No. 32, Personnel and
Rs.150/-
Administrative Reforms (M) Department, dated 01.03.2017]
Note
Applicants who have already registered in One Time online
Registration system and within the validity period of 5 years are
exempted.
b) Examination Fee
Note
Rs.100/-
The Examination fee should be paid at the time of submitting
the online application for this recruitment, unless exemption of
fee is claimed.
Note :
(i) Linking Aadhaar number with One Time Registration (OTR) is mandatory for
applicants. [For further details refer Para 2B of “Instructions to Applicants”]
(ii) One Time Registration is valid for five years from the date of registration.
After completion of five years, the applicant must renew the One Time
Registration by paying the fee prescribed. The One Time Registration is
different from the application for the examination. An applicant should make
an online application separately for each and every examination for which
he intends to appear. [Refer Para 2C of “Instructions to Applicants”]
(iii) Applicants who have already registered for One Time Registration by paying
Rs.150/- towards One Time Registration and having validity of Registration
are exempted from paying the registration fee for this recruitment.
Category Concession
Scheduled Castes/
Scheduled Caste (Arunthathiyars) Full Exemption
Scheduled Tribes Full Exemption
Most Backward Classes/
Denotified Communities Three Free Chances
Backward Classes (Other than Muslim)/
Backward Classes (Muslim) Three Free Chances
Ex-Servicemen Two Free Chances
Persons with Benchmark Disability Full Exemption
a) The total number of free chances availed will be calculated on the basis of
claims made in previous applications.
b) The number of free chances availed by the applicant will be verified by the
Commission at any stage of the selection process.
c) In case an applicant who makes a false claim for exemption from payment of
application fee by suppressing information regarding his/her previous
application(s), his/her candidature shall be rejected after due process and
he/ she will be debarred for a period of one year, from appearing for
examinations and selections conducted by the Commission.
d) Applicants are therefore directed to carefully choose the options “Yes‟ or “No‟
regarding availing the fee concession. The choice made, cannot be modified
or edited after successful submission of online application.
g) Applicants who have availed the maximum number of free chances permitted
/ applicants who do not wish to avail of the fee concession / applicants who
are not eligible for fee concession, shall choose the option “No” against the
query regarding fee concession. Such applicants shall thereafter pay the
requisite fee through the prescribed mode of payment.
h) Failure to pay the prescribed fee in time, along with the online application,
will result in the rejection of application after due process. [For further details
regarding examination fee concessions refer to Para 6 of “Instructions to
Applicants‟]
[For further details regarding the Examination fee, refer Para 2(V) of
“Instructions to Applicants‟]
8. CONCESSIONS
(ii) Persons claiming concession referred to above and other claims made in
the application have to produce evidence for such claim when called for,
otherwise their application will be rejected after due process.
Note:
In all cases, an Ex-Serviceman once recruited to a post in any class
or service or category, cannot claim the concession of being called
an Ex-Serviceman for his further recruitment.
[Section 3(j) of Tamil Nadu Government Servant (Conditions of Service)
Act, 2016].
Minimum Qualifying
Maximum
Subject Duration Marks for selection
Marks
(All Communities)
Single Paper (S.S.L.C Std.)
Part-A
கட்டாத் தமிழ் மாழித் தகுதி ற்றும்
திப்பீட்டுத் ததர்வு
(100 Questions/150 Marks)
Note :
(i) The Part-B of the answer sheets will be evaluated only, if the candidate
secures minimum qualifying marks 40% (i.e., 60 Marks) in Part-A.
(ii) Total marks secured in Part-A and Part-B taken together will be
considered for ranking.
14
(iii) The questions in Part-A will be set in Tamil only. The questions in Part-B
will be set both in Tamil and English.
Based on the marks obtained by the candidates in the Written Examination, the
tentative list of eligible candidates will be announced in the Commission‟s
website for uploading all the certificates in support of their claim for onscreen
certificate verification. After verification, the eligible candidates will be
summoned for Counselling for Departmental Unit allotment in the order of rank
and category to which they are eligible as per the vacancy position.
[Refer Para 18C of “Instructions to Applicants”]
Note :
(i) Applicants shall choose any two District Centres for writing the
examination. Applicants will be allotted a venue in one of those two District
Centres. However, applicants with benchmark disability (Differently-Abled
Persons applicants), will be permitted to choose only one District Centre.
[Refer Para 2(R) of “Instructions to Applicants”]
(ii) Request for change of Examination Centre will not be permitted. [Refer
Para 17(A)(ii) of “Instructions to Applicants”]
(iii) The Commission reserves the right to increase or decrease the number of
Examination Centres and to re-allot the applicants accordingly.
(iv) Applicants should appear for the Written Examination and Counselling at
their own expenses.
Candidates who are in the service of the Indian Union or a State in India or in
the employment of Local Bodies or Universities or Quasi Government
Organizations or Public Sector Units constituted under the authority of the
Government of India or of a State in India, whether in regular service or in
temporary service must inform the Commission of such fact, at the time of
15
applying. Suppression of the fact of employment by candidates shall result in
rejection of candidature after due process. Candidates should produce No
Objection Certificate when called for. [Refer Para 14 (P) of “Instructions to
Applicants‟]
(C) The selection for appointment to the said posts is purely provisional
subject to the final orders in the writ petitions, if any, pending on the files
of the Hon‟ble Madras High Court and Madurai Bench of Madras High
Court.
(F) As per the G.O.(Ms.) No. 51, Welfare of Differently Abled Persons
(DAP3-2) Department, dated 26.12.2017 all the posts in respect of „C‟
and „D‟ categories are eligible for 4% reservation for Differently Abled
Persons. Hence, the Differently Abled Persons may apply to this
recruitment. However, in respect of the posts in Judicial Department, the
persons with blindness and low vision are not eligible as per G.O (Ms) No.
225, Home (Courts) Department, dated 15.06.2021.
(H) If no qualified and suitable women applicants are available for selection
against the vacancies reserved for them, those vacancies will be filled by
male applicants belonging to the respective communal categories.
[Section 26(5) of the Tamil Nadu Government Servants (Conditions of
Service) Act, 2016].
(J) Evidence for all the claims made in the online application should
be uploaded / submitted in time when documents are called for.
Any subsequent claim made after submission of online application
will not be entertained. Failure to upload / submit the documents
within the stipulated time limit will entail rejection of application
after due process.
18
(K) Suppression of following material information in the online application
regarding (i) free chances availed (ii) Employment in the Service of the
Indian Union or a State in India or in the employment of Local Bodies or
University or Quasi Government Organization or Public Sector Units
constituted under the authority of the Government of India or of a State
in India in regular service or temporary service (iii) Wilful suppression of
criminal cases / disciplinary action pending / punishments if any, against
the applicant (iv) violation of undertaking given by the applicant in the
online application etc., may invite suitable penal action including
debarment for a specific period as decided by the Commission for various
recruitments/ selections conducted by the Commission, besides rejection
of application after due process.
(O) One Time Registration is not an application for any post / recruitment.
Though the details/particulars have already been furnished by the
applicants under One Time Registration system, the claims made in the
online application for this recruitment alone will be taken into
consideration. The Commission will not be responsible for any
consequences arising out of furnishing of incorrect and incomplete
details in the application or omission to provide the required details in the
application for this recruitment.
c) Applicants requiring clarification, can contact the office of the Tamil Nadu
Public Service Commission in person or over the Toll-Free No.1800 419
0958 on all working days between 10.00 A.M and 5.45 P.M. Queries
relating to One Time Registration/ online application may be sent to
helpdesk@tnpscexams.in. Other queries may be sent to
grievance.tnpsc@tn.gov.in [Refer in Note (h),(i),(j) under Para 2(V) of
“Instructions to Applicants”]
The Commission shall not publish the final answer key until the
completion of the entire selection process.
5) Applicants should enter the Unique ID and password to view the already
available information and update them. They shall not share the
ID/PASSWORD with any other person or agency.
7) Applicants should select the name of the post for which the applicant
wishes to apply.
(a) After submitting the application, applicants can print / save their
application in PDF format.
(c) Applicants need not send the printout of the online application
or any other supporting documents to the Commission.
Application and all the required certificates will be verified
only when the applicants come up for certificate verification.
[For further details refer Para 2 of “Instructions to Applicants”]
Applicants should upload the required documents for proof in respect of all the
claims made in the application with reference to this notification as and when
called for. If the required certificates are not uploaded by the applicant, within
the stipulated time, his/her application will be rejected after due process.
[For further details refer Para 13 of “Instructions to Applicants”]
Secretary
24
DISCLAIMER
Secretary
25
ANNEXURE-I
CODE
DISTRICT CENTRE
NO.
Ariyalur 3001
Andimadam 3002
ARIYALUR
Sendurai 3003
Udaiyarpalayam 3004
Chengalpattu 3301
Cheyyur 3302
Maduranthakam 3303
Pallavaram 3304
CHENGALPATTU
Tambaram 3305
Thirukalukundram 3306
Tiruporur 3307
Vandalur 3308
Chennai 0101
Alandur 0102
Ambattur 0103
Aminjikarai 0104
Ayanavaram 0105
Egmore 0106
Guindy 0107
Madhavaram 0108
CHENNAI Madhuravoyal 0109
Mambalam 0110
Mylapore 0111
Perambur 0112
Purasavakkam 0113
Sholinganallur 0114
Thiruvottriyur 0115
Tondiarpet 0116
Velacherry 0117
Coimbatore 0201
Aanaimalai 0202
Annur 0203
Coimbatore North 0204
Coimbatore South 0205
Kinathukadavu 0206
COIMBATORE
Madukarai 0207
Mettupalayam 0208
Perur 0209
Pollachi 0210
Sulur 0211
Valparai 0212
26
Cuddalore 0301
Bhuvanagiri 0302
Chidambaram 0303
Kattumannarkoil 0304
Kurinjipadi 0305
CUDDALORE
Panruti 0306
Srimushnam 0307
Thittakudi 0308
Veppur 0309
Virudhachalam 0310
Dharmapuri 0401
Harur 0402
Karimangalam 0403
DHARMAPURI Nallampalli 0404
Palacode 0405
Pappireddipatti 0406
Pennagaram 0407
Dindigul 0501
Atthur 0502
Dindigul East 0503
Dindigul West 0504
Guziliyamparai 0505
DINDIGUL Kodaikanal 0506
Natham 0507
Nilakottai 0508
Oddanchatram 0509
Palani 0510
Vedasandur 0511
Erode 0601
Anthiyur 0602
Bhavani 0603
Gobichettipalayam 0604
ERODE Kodumudi 0605
Modakurichi 0606
Nambiyur 0607
Perundurai 0608
Sathiyamangalam 0609
Kallakurichi 3401
Chinnasalem 3402
KALLAKURICHI Sankarapuram 3404
Tirukoilur 3405
Ulundurpet 3406
27
Kancheepuram 0701
Kundrathur 0702
KANCHEEPURAM Sriperumbudur 0703
Uthiramerur 0704
Walajabad 0705
Nagercoil 0801
Agasteeswaram 0802
Kalkulam 0803
KANNIYAKUMARI Killiyur 0804
Thiruvatar 0805
Thovalai 0806
Vilavankodu 0807
Karur 0901
Aravakurichi 0902
Kadavur 0903
KARUR Krishnarayapuram 0904
Kulithalai 0905
Manmangalam 0906
Pugalur 0907
Krishnagiri 3101
Anjetty 3102
Bargur 3103
Hosur 3104
KRISHNAGIRI
Pochampalli 3105
Sulagiri 3106
Thenkanikottai 3107
Uthangarai 3108
Madurai 1001
Kallikudi 1002
Madurai East 1003
Madurai North 1004
Madurai South 1005
Madurai West 1006
MADURAI
Melur 1007
Peraiyur 1008
Thirumangalam 1009
Thiruparankundram 1010
Usilampatti 1011
Vadipatti 1012
Mayiladuthurai 3801
Kuthalam 3802
MAYILADUTHURAI
Sirkali 3803
Tharangambadi 3804
Nagapattinam 1101
Kilvelur 1102
NAGAPATTINAM
Thirukkuvalai 1103
Vedaranyam 1104
28
Namakkal 1201
Kumarapalayam 1203
Mohanoor 1204
NAMAKKAL Paramathi Velur 1205
Rasipuram 1206
Senthamangalam 1207
Tiruchengode 1208
Perambalur 1401
Alathur 1402
PERAMBALUR
Kunnam 1403
Veppanthattai 1404
Pudukkottai 1501
Alangudi 1502
Aranthangi 1503
Avudaiyarkoil 1504
Gandarvakottai 1505
Iluppur 1506
PUDUKKOTTAI
Karambakudi 1507
Kulathur 1508
Manamelkudi 1509
Ponnamaravathi 1510
Thirumayam 1511
Viralimalai 1512
Ramanathapuram 1601
Kadaladi 1602
Kamuthi 1603
Kezhakarai 1604
RAMANATHAPURAM Mudukulathur 1605
Paramakudi 1606
Rajasingamangalam 1607
Rameswaram 1608
Tiruvadanai 1609
Ranipet 3501
Arakkonam 3502
Arcot 3503
RANIPET Kalavai 3504
Nemili 3505
Sholingur 3506
Walajah 3507
Salem 1701
Attur 1702
Edapadi 1703
Gangavalli 1704
SALEM
Kadaiyampatti 1705
Mettur 1706
Omalur 1707
Pethanayakanpalayam 1708
29
Salem South 1709
Salem West 1710
Sankari 1711
Vazhapadi 1712
Yercaud 1713
Sivagangai 1801
Devakottai 1802
Ilayankudi 1803
Kalaiyarkovil 1804
SIVAGANGAI Karaikudi 1805
Manamadurai 1806
Singampunari 1807
Thirupuvanam 1808
Tirupathur 1809
Tenkasi 3601
Alangulam 3602
Kadayanallur 3603
Sankarankovil 3604
TENKASI
Shenkottai 3605
Sivagiri 3606
Thiruvengadam 3607
Veerakeralampudur 3608
Thanjavur 1901
Boothalur 1902
Kumbakonam 1903
Orathanadu 1904
THANJAVUR Papanasam 1905
Pattukottai 1906
Peravurani 1907
Thiruvaiyaru 1908
Thiruvidaimaruthur 1909
Udhagamandalam 1301
Coonoor 1302
THE NILGIRIS Gudalur 1303
Kothagiri 1304
Kundah 1305
Pandalur 1306
Theni 2001
Aandipatti 2002
THENI Bodinayakanur 2003
Periyakulam 2004
Uthamapalayam 2005
Thiruvallur 2101
Avadi 2102
THIRUVALLUR Gummidipoondi 2103
Pallipattu 2104
Ponneri 2105
30
Poonamallee 2106
R.K.Pet 2107
Tiruthani 2108
Uthukottai 2109
Thiruvannamalai 2201
Arni 2202
Chengam 2203
Chetpet 2204
Cheyyar 2205
Jamunamarathur 2206
THIRUVANNAMALAI
Kalasapakkam 2207
Kilpennathur 2208
Polur 2209
Thandramet 2210
Vandavasi 2211
Vembakkam 2212
Thiruvarur 2301
Kodavasal 2302
Mannargudi 2304
THIRUVARUR Nannilam 2305
Needamangalam 2306
Thiruthuraipoondi 2307
Valangaiman 2308
Thoothukudi 2401
Eral 2402
Ettayapuram 2403
Kayathar 2404
Kovilpatti 2405
THOOTHUKUDI
Ottapidaram 2406
Sattankulam 2407
Srivaikundam 2408
Tiruchendur 2409
Vilathikulam 2410
Tiruchirappalli 2501
Lalgudi 2502
Manachanallur 2503
Manapparai 2504
Marungapuri 2505
Musiri 2506
TIRUCHIRAPPALLI
Srirangam 2507
Thottiam 2508
Thuraiyur 2509
Tiruchirappalli West 2510
Tiruchirappalli East 2511
Thiverumbur 2512
31
Tirunelveli 2601
Ambasamudram 2602
Cheranmahadevi 2603
Manur 2604
TIRUNELVELI
Nanguneri 2605
Palayamkottai 2606
Radhapuram 2607
Thisayanvilai 2608
Tirupathur 3701
Ambur 3702
TIRUPATHUR
Natrampalli 3703
Vaniyambadi 3704
Tiruppur 3201
Avinashi 3202
Dharapuram 3203
Kangeyam 3204
Madathukkulam 3205
TIRUPPUR
Uthukuli 3206
Palladam 3207
Tiruppur North 3208
Tiruppur south 3209
Udumalaipettai 3210
Vellore 2701
Aanaikattu 2702
Gudiyatham 2703
VELLORE
K.V.Kuppam 2704
Katpadi 2705
Pernampet 2706
Villupuram 2801
Gingee 2802
Kandachipuram 2803
Marakanam 2804
VILLUPURAM Melmalaiyanur 2805
Thiruvennainallur 2806
Tindivanam 2807
Vanur 2808
Vikravandi 2809
Virudhunagar 2901
Aruppukottai 2902
Kariyapatti 2903
Rajapalayam 2904
Sathur 2905
VIRUDHUNAGAR
Sivakasi 2906
Srivilliputhur 2907
Tiruchuli 2908
Vembakottai 2909
Watrap 2910
32
ANNEXURE-II
3. பிஞி்தழுது.
21. தஜாழி் .
குதி-ஆ
இ்கிஜ்
1. திரு்குட் தாஞ ்ாச தஓ் தி் , தஜட் தா் ் , தாகஞ ஙிஞ்பு்
(இரு்கங்து அதிாஞஜ் ஜ்டுஜ் )
அச்பு, ்பு, ் ழ, த் ழ, அறிழ, அ்ஜ் , எழு்ஜ் , தாகட, ங்பு,
ணா் கஜ, ாஜ் , ணலி, எ்புஞணறி் , தஓ் ஙச்றி, ஓாச்டா்கஜ,
தஞிாகஞ் துக் தா் , தாரு் தஓ் ணக, ழகச்தி்ஜ் ,
இசிகண கூட் , ஊ்பககஜ, ஈக, தஞிங்து தஓ் ணக,
இச்சா தஓ் ாகஜ, கூா ங்பு, உழ.
குதி-இ
ப் அறிகஞ ்ளுஜ் , ப் ் தா்டுஜ்
14. பஜ் – ஊருஜ் தருஜ் , தாட் டஜ் ஜாட் டஜ் ட் றி தஓ் தி் .
18. பஞ ் ணிஜ் – தா் லி் ஆ் ழ் – ட் ஒ் ் –
தாஞ ்ாச தஓ் தி் .
19. உதண ஜருங்து – தஙா் தீஞ ்்குஜ் பெலிக் தாஞ ்ாச தஓ் தி் .
Part-B
General Studies
(SSLC Standard)
(Topics for Objective Type)
1. GENERAL SCIENCE
2. CURRENT EVENTS
3. GEOGRAPHY
5. INDIAN POLITY
6. INDIAN ECONOMY
Signature of Candidate________________________________________
I/We do hereby certify that I/We have examined (full name)Thiru / Thirumathi /
Selvan / Selvi _______________________________________ a Candidate ____________
for employment under the Government as __________ in the
__________________________________ Office in the
_________________________________________________ Department and whose
signature is given above and cannot discover that he/she has any disease, communicable or
otherwise constitutional affliction or bodily infirmity/except that his/her weight is in excess
of/below the standard prescribed or except.
His/Her age is according to his / her own statement ________ years and by
appearance about years.
I/We also certify that he/she has marks of Small Pox/ Vaccination.
On full inspiration
Chest measurement in Inches On full expiration
Difference expansion
Height in ft.
Weight in kg.
Cardio–Vascular System
Respiratory System
His/Her vision is normal
Hypermetropic/ Myopic/ Astigmatic/
[Here enter the degree of defect and the strength of correction glasses]
Hearing is normal / defective (much or slight)
Urine-Does chemical examination show
(i) Albumen (ii) Sugar State specific gravity
Personal marks (at least two should be mentioned) For Identification
1.
2.
Signature:
Rank:
Designation: President
Members (i)
(ii)
Station: Station:
Date: Date:
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The candidate must make the statement required below prior to his / her medical
examination and must sign the declaration appended thereto. His attention is specially
directed to the warning contained in the note below:-
I declared all the above answers to be to the best of my belief, true and correct.
Candidate‟s Signature
Note: The candidate will be held responsible for the accuracy of the above statement by
willfully suppressing any information he will incur the risk of losing the appointment
and if appointed, of forfeiting all claim to superannuation allowance or gratuity.
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ANNEXURE-IV
ANNEXURE-V
Secretary