GOVT OF NCT OF DELHI
INDIRA GANDHI INSTITUTE OF PHYSCIAL EDUCATION & SPORTS SCIENCES

DEPARTMENT OF PHYSICAL EDUCATION AND SPORTS SCIENCES (UNIVERSITY OF DELHI),
BLOCK-B, VIKAS PURI, NEW DELHI-18

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MEDICAL FITNESS CERTIFICATE FORM FOR
ADMISSION TO IGIPESS
(University of Delhi)
 

IGIPESS

Block-B, Vikas Puri Delhi-1100 18

University of Delhi

Form No...................... Entrance Test Roll No................
  Interview Roll No.......................
(To be filled in by the office)

ADMISSION TEST CARD
(2007-2008)

Write in BLOCK Letter

 

1. Name (Mr./Mrs.)..................................................................




 
2. Father's/ Guradian's Name...................................................
3. Date of Birth.......................................................................
4. Address.............................................................................
5. Preferred Game/Sports For Playing Ablility Test
(i)...........................................(ii)............................................



Staff I/C.........................................




Signature of Students


DO NOT WRITE BELOW THIS

Signatures (sign.) will be obtained at the time of the Test and Interview
 

Sign. of Candidate

Incharge

1. Written Test    
2. Physical Fitness Test    
3. Playing Test    
4. Interview    
5. Medical Examination    
 
Form No……………
Dated:………………….
1.      COURSE OPTED………………………………………………………………………….
2.      NAME :……………………………………………………………………………………..
3.      AGE & SEX………………………………………………………………………………..
4.      FATHER’S NAME…………………………………………………………………………
5.      PULSE :……………………………………………………………………………………..
6.      B.P. :………………………………………………………………………………………..
7.      WEIGHT :…………………………………………………………………………………..
8.      HEIGHT :……………………………………………………………………………………
9.      CHEST CIRCUMFERENCE:       NORMAL :………………………………….
                                                 EXPANDED :………………………………
10.    CVS :……………………………………………………………………………............
11.    CHEST :……………………………………………………………………………………..
12.    ABDOMEN :………………………………………………………………………………...
13.    EYE :            (i)  Colour Vision
                           (ii)  Visual acuity……………………......
                           (a)  Without Glasses……………………...
                           (b)  With Classes…………………………...

  
   

14.  After careful personal Examination of Mr./Ms. ………………………………………………..
I hereby certify that he/she is fit to undergo a minimum of 4 hours of vigourous training daily.

 

SIGNATURE OF MEDICAL OFFICER
(with stamp and Registration Number)