Schedule (Related to Rule 4)

Format of Certificate of Eligibility
It is hereby certified that on doing the health examination of Mr./ Miss………………………….. is found to be physically and mentally healthy, so he/she shall be able to do the ……………… service of ……………………… 

Enterprise.
Description of Child:
(a) Name, Caste:-
(b) Child’s Address:-
(c) Name, Caste, Address of Child’s Father, Mother:-
(d) Thumb Impression of Right Hand of the Child:-
(e) Signature of Child:-
(f) Date:-
Doctor Authenticating:-
(a) Name, Caste, Address:-
(b) Signature:-
(c) Registration Number of Nepal Medical Council:-
(d) Date:-
Note: This certificate shall be valid for a year.