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Get Cs Form 211 Revised 2018

CSC FORM NO. 211 Revised August 1998 MEDICAL CERTIFICATE For employment PHILIPPINE CIVIL SERVICE INSTRUCTION 1. This Medical Certificate should be accomplished by a government physician* 2. Attached this certificate to original appointment and reinstatement. FOR THE PROPOSED APPOINTEE NAME Last First Middle or if married woman Maiden Name AGENCY/ADDRESS ADDREESS SEX AGE PROPOSED POSITION CIVIL STATUS Pre-Employment Medical Physical Test Blood Test Urinalysis Chest X-Ray Drug Test Neuro-Psychiatric Examination if necessary NOTE ALL RESULTS OF EXAMINATION MUST BE ATTACHED TO THIS FORM FOR THE PHYSICIAN I hereby certify that I have personally examined the abovenamed individual and found her / him to be physically and medically fit / unfit for PRINTED NAME / SIGNATURE OF PHYSICIAN CERTIFICATE NUMBER AFFIX Documentary Stamp here OTHER INFORMATION ABOUT THE PROPOSED APPOINTEE OFFICIAL DESIGNATION HEIGHT Feet Lbs. This Medical Certificate should be accomplished by a government physician* 2. Attached this certificate to original appointment and reinstatement. FOR THE PROPOSED APPOINTEE NAME Last First Middle or if married woman Maiden Name AGENCY/ADDRESS ADDREESS SEX AGE PROPOSED POSITION CIVIL STATUS Pre-Employment Medical Physical Test Blood Test Urinalysis Chest X-Ray Drug Test Neuro-Psychiatric Examination if necessary NOTE ALL RESULTS OF EXAMINATION MUST BE ATTACHED TO THIS FORM FOR THE PHYSICIAN I hereby certify that I have personally examined the abovenamed individual and found her / him to be physically and medically fit / unfit for PRINTED NAME / SIGNATURE OF PHYSICIAN CERTIFICATE NUMBER AFFIX Documentary Stamp here OTHER INFORMATION ABOUT THE PROPOSED APPOINTEE OFFICIAL DESIGNATION HEIGHT Feet Lbs.

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