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Disability Certificate Format

Disability Certificate Format


The C. M. O/P.M.O

Sub: Application for issuing Disability Certificate of the ____


The applicant submits as under:-

1- That applicant ____ S/o ____ met with accident on ____ Near ____ and he sustained injuries over his body. The applicant was remained under the treatment of ____ and the MLR no. ____ dated ____ was prepared.

2- That the applicant has filed a claim petition under section ___ of the ____ in the court of ____ and the same is pending.

3- That the applicant requires the permanent disability certificate for proving his permanent disability.

You are therefore, requested that the permanent disability Certificate of the applicant _______ may kindly be released to the applicant as per rules and regulations.

Dated _____                                                                                                                   Applicant

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