PERFORMA FOR MEDICAL FITNESS CERTIFICATE FOR FOOD HANDLERS
( See Para No. 10.1.2, Part - II, Schedule - 4 of FSS Regulation, 2011 )
It is Certified that Shri/Smt,/Miss employed with M/s coming in direct contact with food items has been carefully examined* by me on date Based on the medical examination conducted He/She found free from any infictious or communicable diseases and the person is Fit to work in the above mentioned food establishment.
Name and Signature with Seal
of Registered Medical Practitioner / Civil Surgeon
* Medical Examination to be conducted :
1. Physical Examination.
2. Eye Test.
3. Skin Examination.
4. Compliance with schedule of Vaccine to be inoculated against enteric group of diseases.
5. Any test required to confirm any communicable or infectious disease which the person suspected to be suffering from on clinical examination.