COMPULSORY HEALTH CERTIFICATE FOR SHRI AMARNATHJI YATRA 2013
Download HEALTH CERTIFICATE FORM
Please take care of beneath diseases
DECLARATION: Have you suffered from or have history of any of the following:
a) Breathlessness Yes No b) Diabetes Yes No
c) Respiratory/ lung ailment Yes No d) High Blood pressure Yes No
e) Blood disorder Yes No f) Asthma Yes No
g) Bleeding tendencies Yes No h) Epilepsy Yes No
i) Heart ailment Yes No j) Nervous breakdown Yes No
k) Joint Pains Yes No l) High altitude/mountain sickness Yes No
m) Discharge from ear Yes No n) History of stroke/ paralysis Yes No
o) Are you a smoker Yes No p) Are you pregnant: Yes No
with
