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Unformatted text preview: nagement at IIM Indore - Application 3 (VII) MEDICAL HISTORY Please state whether you have any existing physical disability or any chronic illness, including mental illness, which could affect your studies at the Institute. If you have suffered from any chronic illness, including mental illness, in the past, please provide details below: Nature of illness When suffered Date of completion of treatment Remarks, if any 1. 2. 3. It is mandatory for all applicants to ensure that they are medically fit for joining the programme and they shall get the medical fitness certificate from authorised doctor/ hospital preferably from Government Hospitals. Please note that you are not required to send any medical certificate along with this application form. (VIII) DECLARATION I clearly understand that if I am selected, I will be allowed to join the programme only if I satisfy all requirements of the programme including the submission of a certificate at the time of registration from Principal of my school that except for declaration of results, I have completed all requirements for obtaining XII Std. / Higher Secondary / Equivalent qualification and that I would have to produce...
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This document was uploaded on 03/12/2014.

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