Get Form Iv Disability Bcertificateb In Cases Other Than Those Bb - Ncbs Res

This guide provides a comprehensive overview of how to fill out the FORM IV DISABILITY CERTIFICATE online. It is designed to assist users, regardless of their experience with legal documents, in providing clear and accurate information when completing this important form.

Follow the steps to fill out the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the name and address of the medical authority that is issuing the certificate. Ensure you include the certificate number and date in the designated fields.
3. Attach a recent passport-sized photograph of the person with a disability, making sure it shows only their face. This should be appropriately attested.
4. In the certification section, clearly state the full name of the individual being evaluated (Son/Smt./Kum.) along with their relationship to the issuing authority.
5. Fill in the date of birth and age of the person with a disability, noting their gender in the specified format (Male/Female).
6. Enter the registration number and the permanent address of the individual, including relevant details such as house number, village/street, post office, district, and state.
7. In the disabilities section, select all applicable disabilities by checking the corresponding boxes. Be prepared to indicate the affected parts of the body.
8. Detail the extent of permanent physical impairment or disability in percentage form according to the guidelines provided.
9. Select the condition of the disability as either progressive, non-progressive, likely to improve, or not likely to improve.
10. If a re-assessment of disability is needed, indicate whether it is necessary or recommended, and specify the period for re-assessment.
11. Provide information regarding proof of residence by listing the nature of the document, its date of issue, and the authority that issued the certificate.
12. Ensure that the certificate is signed by the authorized signatory of the notified medical authority, including their name and seal.
13. If applicable, obtain the countersignature and seal of the Chief Medical Officer or Medical Superintendent.
14. Finally, have the individual in whose favor the disability certificate is issued provide their signature or thumb impression.
15. Review all filled sections for accuracy before saving your changes. You can then download, print, or share the completed form.

Complete your FORM IV DISABILITY CERTIFICATE online today to ensure timely processing.