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RAILWAY RECRUITMENT BOARD Annexure-6

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					                                                                                                                                              Annexure-6

                                               RAILWAY RECRUITMENT BOARD

                                                                                                                                                       Paste here your recent colour
  Proforma for Medical Certificate to be obtained from an Eye Specialist by candidates                                                                passport size photograph of size
                                                                                                                                                                4 cm x 5 cm
  applying for the posts of Assistant Station Master/Assistant Loco Pilot/Motorman                                                                        (The colour photograph
                                                                                                                                                          should not be more than
  I have checked up Smt./Shri/Kumari*............................................................................ who                                          3 months old)
                                                                                                                                                         The photograph should be
                                                                                                                                                                  attested
  has applied for post of Assistant Station Master/Assistant Loco Pilot/Motorman* in                                                                       by the Eye Specialist

  Railways. Acuity of vision / colour vision of Smt./Shri/Kumari*......................................

  .....................................has been tested in view of the following standards required for
                                                                                                                                                     Signature of candidate in theabove
  appointment on the Railways.                                                                                                                           box below the photograph



               Post                           Class                Distant Vision                      Near                Colour Vision on Ishihara
                                                                                                      Vision
Assistant Loco Pilot /                         A-1                6/6, 6/6 without                 Sn 0.6/0.6                            Normal
Motorman*                                                              glasses                      without
                                                                  with fogging test                 glasses
                                                                 (must NOT accept
                                                                        +2D)
Assistant Station                              A-2                 6/9, 6/9 without                Sn 0.6/0.6                            Normal
Master                                                                 glasses                      without
                                                                  (No fogging test)                 glasses

* Please delete the words which are not applicable.

Smt./Shri/Kumari*............................................................................................................................... fully conforms to

the above vision standards.

Name of the Eye Specialist ............................................................................

Registration No. of the Eye Specialist...............................................................




                                                                                                                                  (Signature of the Eye Specialist)
Place :

Date :
                                                                                                                                      (Seal of the Eye Specialist)

				
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