7_Form-Of-Application-Declaration-as-to-the-Physical-Fitness - FORM 1[RULE 5(2 Application-cum declaration as to the physical fitness 1 Name of

7_Form-Of-Application-Declaration-as-to-the-Physical-Fitness

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FORM 1 [RULE 5(2)] Application -cum- declaration as to the physical fitness 1 Name of the applicant _____________________________________ 2 Son/wife/daughter of _____________________________________ 3 Permanent Address _____________________________________ 4 Temporary address _____________________________________ Official address (if any) _____________________________________ 5 (a) Date of birth _____________________________________ (b) Age on date of application _____________________________________ 6 Identification Mark (1) _____________________________________ (2) _____________________________________ Declaration: a) Do you suffer from epilepsy, or from sudden attack of loss of consciousness or giddiness from any cause ? b) Are you able to distinguish with each eye (or if you have held a driving Licence to drive a motor vehicle for a period of not less than five year & if you lost, the sight of one eye after the said period of five years & if the application is for driving a light motor vehicle other transport vehicle fitted with an outside mirror on the steering wheel side) or with one eye, at a distance of 25 meters in good day light (with glasses, if worn) a motor car number plate ?Yes/No than a

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