Annexure-2

CERTIFICATE OF DISABILITY FOR NEET ADMISSIONS

(As per MCI Gazette Notification No. MCI-18(1)/2018-Med./187262 dated 5th Feb, 2019/
14th May,2019 for admission to Medical Courses in All India Quota)

Certificate No :. 2024-Aug/XXXX Certificate Date :. 00-XXX-2024

Name of the Designated Disability

Certification Centre
This to certify that Dr. / Mr. / Ms. PHOTOGRAPH
Age Son/ Daughter of Mr.
NEET Roll No. Rank No.

Has the following Disability

Disability Details
Sr Disability Type Type of Disability Specified Disability Disability %
No
1

Conclusion: Based on quantification of Disability The Disability of candidate is between 40- 80%. Hence, the
candidate iseligible to pursue medical education and also eligible to claim PwD reservation.

The Disability Certification Board certifies that the candidate is Eligible for admission in Medical/ Dental courses and to
avail5% PwD reservation as per the NMC/ MCI Gazette Notification.

Eligible for PWD Quota, Eligible for Medical/Dental Course

Functional competency with the aid of Assistive devices in case of Locomotor*/ Visual*/ Hearing* Impairment, if any.
No

Sign & Name: Sign & Name: Sign &

Name:

Assistant Professor Associate Professor Associate Professor

Neurology Orthopedics Medicine

Disclaimer :This Certificate is Provisional and will be verified by the allotted college authorities at the time of admission. The candidate may be
subjected todiagnostic test to specify the level of disability again at the allotted college in case of any ambiguity. The certificate may be cross
verified by the admitting college from the Disability Board from where the certificate has been issued. Hence, the Designated Disability Boards and
the candidates are advised to preserve the records for any future reference. The Disability Certificate is valid for this academic session only.

Downloading Date: August XX, 2024 00:0

QR CODE

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 ANNEXURE-3
PROFORMA FOR SCHEDULED CASTE AND SCHEDULED TRIBE CERTIFICATE

Form of certificate as prescribed in M.H.A., O.M., No. 42/21/49-N.G.S. dated the 28.1.1952, as revised in Dept. of
Per- & A.R. letter No. 36012/6/76-Est. (S.CT), dated the 29.10.1977, to be produced by candidate belonging to a
Scheduled Caste or a Scheduled Tribe in support of his/her claim.
CASTE CERTIFICATE
This is to certify that Shri/Smt./Kum.* ------------------------------------------- son/daughter* of ------------------------------------- of
village/town*---------------------------in district/Division*---------------of the State/Union Territory* -------------------------
belongs to the -------------------- Caste/ Tribe which is recognized as a Scheduled Caste/Scheduled Tribe*under:
 The Constitution (Scheduled Caste) Order, 1950
 The Constitution (Scheduled Tribe) Order, 1950
 The Constitution (Scheduled Caste) (Union Territories) Order,1951
 The Constitution (Scheduled Tribe) (Union Territories) Order,1951
1. (as amended by the Scheduled Caste and Scheduled Tribe Lists (Modification) order, 1956, the Bombay Re-
organization Act, 1960, the Punjab Re- organization Act, 1966, the State of Himachal Pradesh Act, 1970 the North
Eastern Areas (Re-organization) Act, 1971 and the Scheduled Castes and Scheduled Tribes Orders, (Amendment) Act,
1976).
 The Constitution (Jammu and Kashmir) Scheduled Caste Order, 1956.
 The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959.
 The Constitution (Dadra and Nagar Haveli) Scheduled Caste Order, 1962.
 The Constitution (Dadra and Nagar Haveli) Scheduled Tribes, Order, 1962.
 The Constitution (Puducherry) Scheduled Caste Order, 1964
 The Constitution (Uttar Pradesh) Scheduled Tribes, Order, 1967.
 The Constitution (Goa, Daman & Diu) Scheduled Caste Order, 1968.
 The Constitution (Goa, Daman & Diu) Scheduled Tribes, Order, 1968.
 The Constitution (Nagaland) Scheduled Tribes Order, 1970.
 The Constitution (Sikkim) Scheduled Caste Order, 1978.
 The Constitution (Sikkim) Scheduled Tribes Order, 1978.
2. Applicable in the case of Scheduled Caste/Schedule Tribe persons who have migrated from one State/Union
Territory Administration:
This certificate is issued on the basis of the Scheduled Caste/Scheduled Tribe* certificate issued to Shri/Smt*----------
-father/mother of Shri/Smt/Kum* - of village/town* -
----- in District/Division* -----------------------------of the State/Union Territory*------------------------ who belongs to the ----
--------------------------caste/tribe which is recognized as a Scheduled Caste/Scheduled Tribe* in the State/Union
Territory* ---------------------issued by the --------------------- (name of prescribed authority) vide their No---------------------
- date
3. Shri*/Smt.*/Kum* -------------------------and/or his/her* family ordinary reside (s) in village/town* ----------------------------- of
the State/Union Territory of----------------- --.

Signature

Place-------------------- State/Union Territory ** Designation-------------------

Date ---------------------- (With seal of Office)
* Please delete the words which are not applicable.
 Please quote specific Presidential Order.
 Delete the paragraph which is not applicable.
** Should be signed by the Authorities empowered to issue Scheduled Caste/Scheduled Tribe certificates as
specified above.

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 ANNEXURE-4
PROFORMA FOR OTHER BACKWARD CLASS (OBC-NCL) CERTIFICATE

(Certificateto be produced by Other BackwardClass applying for admission to Central Educational Institute (CEIS) under
the Government of India)
This is to certify that Shri/Smt./Kum./Dr. Son/Daughter of
Shri/Dr. of Village/Town District/Division in the
State belongs to the Community which is recognized as a backward class under:
(i) Resolution No. 12011/68/93-BCC(C) dated 10/09/93 published in the Gazette of India Extraordinary part I Section I
No. 186 dated 13/09/93.
(ii) Resolution No. 12011/9/94-BCC dated 19/10/94 published in the Gazette of India Extraordinary part I Section I No.
163 dated 20/10/94.
(iii) Resolution No. 12011/7/95-BCC dated 24/05/95 published in the Gazette of India Extraordinary part I Section I No.
88 dated 25/05/95.
(iv) Resolution No. 12011/96/94-BCC dated 09/03/96.
(v) Resolution No. 12011/44/96-BCC dated 06/12/96 published in the Gazette of India Extraordinary part I Section I No.
120 dated 11/12/96.
(vi) Resolution No. 12011/13/97-BCC dated 03/12/97.
(vii) Resolution No. 12011/99/94-BCC dated 11/12/97.
(viii) Resolution No. 12011/68/98-BCC dated 27/10/99.
(ix) Resolution No. 12011/88/98-BCC dated 06/12/99 published in the Gazette of India Extraordinary part I Section I No.
270 dated 06/12/99.
(x) Resolution No. 12011/36/99-BCC dated 04/04/2000 published in the Gazette of India Extraordinary part I Section I
No. 71 dated 04/04/2004.
(xi) Resolution No. 12011/44/99-BCC dated 21/09/2000 published in the Gazette of India Extraordinary part I Section I
No. 210 dated 21/09/2000.
(xii) Resolution No. 12015/09/2000-BCC dated 06/09/2001.
(xiii) Resolution No. 12011/01/2001-BCC dated 19/06/2003.
(xiv) Resolution No. 12011/04/2002-BCC dated 13/01/2004.
(xv) Resolution No. 12011/09/2004-BCCdated 16/01/2006 published in the Gazette of India Extraordinary part I Section
I No. 210 dated 16/01/2006.
(xvi) Resolution No. 20012/129/2009/-BC-II dated 04/03/2014 published in the Gazette of India Extraordinary Part I
section I no. 63 dated 04/03/2014.
(xvii) Resolution No. F.No.12015/05/2011-BC-II dated 17th February, 2014

Shri/Smt./Kum. and/or his family ordinarily reside(s) in the

District/Division of State.
This is also to certify that he/she does not belong to the persons/section (creamy layer) mentioned in Column 3 of the
Scheduled to the Government of India. Department of Personnel & Training O.M. No. 36012/22/93-Estt. (SCT) dated
08/09/93 which is modified vide OM No. 36033/3/2004 Estt. (Res.) dated 09.03.2004 or the latest notification of the
Government of India.
Dated:
District Magistrate/Competent Authority Seal
NOTE: Any Resolution Number not mentioned/ corrective Ness in above list (1-17) may be verified from central list at national
commission for Backward classes website and be may accepted as valid after confirmation from site by verifying institutes.
(a) The Term Ordinarily used here will have the same meaning as in Section 20 of the Representation of the People
Act, 1950.
(b) The authorities competent toissue Caste Certificates are indicated below:
(i) District Magistrate/Additional Magistrate/Ist Class Stipendiary Magistrate/Sub-Divisional Magistrate/Taluka
Magistrate/Executive Magistrate/Extra Assistant Commissioner (not below the rank of 1 st Class Stipendiary
Magistate.)
(ii) Chief Presidency Magistrate/Additional Chief presidency Magistrate/Presidency magistrate.
(ii) Revenue Officer not below the rank of Tehsildar.
(iv) Sub-Divisional Officer of the area where the candidateand/or his family resides.
(c) The annual income/status of the parents of the applicant should be based on financial year ending March 31, 2024.
 Annexure - 5
Performa for EWS Certificate

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