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    CSC Form 211 - Medical Certificate PDF

    Uploaded by

    Michael Angelo Perez
    The document is a medical certificate form for employment in the Philippine civil service. It requires information about the proposed appointee such as name, address, age, sex, civil status, and position applied for. It also lists required pre-employment medical tests and examinations, including blood test, urinalysis, chest x-ray, drug test, and neuro-psychiatric examination if necessary. The examining physician must certify that the applicant is physically and mentally fit for employment and sign the certificate.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    CSC Form 211 - Medical Certificate PDF

    Uploaded by

    Michael Angelo Perez
    739 views1 page
    The document is a medical certificate form for employment in the Philippine civil service. It requires information about the proposed appointee such as name, address, age, sex, civil status, and position applied for. It also lists required pre-employment medical tests and examinations, including blood test, urinalysis, chest x-ray, drug test, and neuro-psychiatric examination if necessary. The examining physician must certify that the applicant is physically and mentally fit for employment and sign the certificate.

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    CSC FORM 211 - MEDICAL CERTIFICATE.pdf

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    The document is a medical certificate form for employment in the Philippine civil service. It requires information about the proposed appointee such as name, address, age, sex, civil status, and position applied for. It also lists required pre-employment medical tests and examinations, including blood test, urinalysis, chest x-ray, drug test, and neuro-psychiatric examination if necessary. The examining physician must certify that the applicant is physically and mentally fit for employment and sign the certificate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    739 views1 page

    CSC Form 211 - Medical Certificate PDF

    Uploaded by

    Michael Angelo Perez
    The document is a medical certificate form for employment in the Philippine civil service. It requires information about the proposed appointee such as name, address, age, sex, civil status, and position applied for. It also lists required pre-employment medical tests and examinations, including blood test, urinalysis, chest x-ray, drug test, and neuro-psychiatric examination if necessary. The examining physician must certify that the applicant is physically and mentally fit for employment and sign the certificate.

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    PHILIPPINE CIVIL SERVICE

    CSC Form No. 211 (Revised August 1998)


    MEDICAL CERTIFICATE
    For Employment

    INSTRUCTIONS

    1. This medical certificate should be accomplished by the government physician.


    2. Attach this certificate to original appointments and reinstatements.

    FOR THE PROPOSED APPOINTEE

    NAME (Last, First, Middle or if married woman, Maiden Name AGENCY/ADDRESS

    ADDRESS
    PROPOSED POSITION
    AGE SEX CIVIL STATUS

    Pre-Employment Medical-Physical Test

    1. Blood Test
    2. Urinalysis
    3. Chest X-ray
    4. Drug Test
    5. Neuro-Psychiatric Examination Result (if necessary)

    NOTE: ALL RESULTS OF EXAMINATIONS MUST BE ATTACHED TO THIS FORM.

    FOR THE PHYSICIAN

    I hereby certify that I personally examined the above-named individual


    and found her/him to be physically and mentally fit for employment. Documentary
    Stamp

    PRINTED NAME/SIGNATURE OF PHYSICIAN CERTIFICATE NUMBER


    OTHER INFORMATION ABOUT THE
    PROPOSED APPOINTEE

    OFFICIAL DESIGNATION HEIGHT WEIGHT BLOOD


    (stripped) TYPE

    AGENCY DATE EXAMINED

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