Medical Certificate for Shri Mani Mahesh Pilgrimage

Medical Certificate for Shri Mani Mahesh Pilgrimage

This is to certify that Mr./Ms./Mrs. [Applicant’s name] is fit to undertake the journey to the Shri Mani Mahesh Yatra, 2023.

The applicant has declared that they do not have any of the following medical conditions:

• Breathlessness
• Diabetes
• Respiratory/Lung ailment
• High Blood pressure
• Blood Disorder
• Asthma
• Bleeding tendencies
• Epilepsy
• Heart Ailment
• Nervous breakdown
• Joint pains
• High altitude/mountain sickness
• Discharge from ear
• History of stroke/paralysis
• Smoking
• Pregnancy (Applicable to female yatris)

The applicant has also declared that they do not have any of the following medical histories:

• Heart Attack
• Sudden death in family members
• Major injury
• Other ailment
• History of surgery
• Medication
• Allergies to drugs, foods, and chemicals

I have examined the applicant and, based on the information they have provided, I believe that they are fit to undertake the journey to the Shri Mani Mahesh Yatra, 2023.

Dated: [Date]

Signature/Thumb impression of the Applicant

Name of the Doctor: [Doctor’s name]

Designation: [Doctor’s designation]

Signature and seal of Authorized Medical Authority

Date of issue: [Date]

MCI/State Medical Council Registration No.: [Registration number]