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    GP 69 Form - Medical Examination

    Uploaded by

    Denley Kim
    This document is a medical examination form for candidates seeking temporary, contract, or permanent employment or an extension of their tour of duty with the Kenyan government. It consists of two parts: Part 1 is completed by the candidate's ministry or department and sends the candidate for a medical exam. Part 2 is completed by the examining medical officer and returned to the ministry with their determination of whether the candidate is fit for the intended employment. The form also includes notes on its completion and questions for the candidate to answer regarding any past hospitalizations, medical treatments, or illnesses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    GP 69 Form - Medical Examination

    Uploaded by

    Denley Kim
    83K views2 pages
    This document is a medical examination form for candidates seeking temporary, contract, or permanent employment or an extension of their tour of duty with the Kenyan government. It consists of two parts: Part 1 is completed by the candidate's ministry or department and sends the candidate for a medical exam. Part 2 is completed by the examining medical officer and returned to the ministry with their determination of whether the candidate is fit for the intended employment. The form also includes notes on its completion and questions for the candidate to answer regarding any past hospitalizations, medical treatments, or illnesses.

    Original Description:

    MEDICAL EXAMINATION FORM - KENYA PUBLIC WORKERS

    Original Title

    Gp 69 Form - Medical Examination

    Copyright

    © Attribution Non-Commercial (BY-NC)

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    This document is a medical examination form for candidates seeking temporary, contract, or permanent employment or an extension of their tour of duty with the Kenyan government. It consists of two parts: Part 1 is completed by the candidate's ministry or department and sends the candidate for a medical exam. Part 2 is completed by the examining medical officer and returned to the ministry with their determination of whether the candidate is fit for the intended employment. The form also includes notes on its completion and questions for the candidate to answer regarding any past hospitalizations, medical treatments, or illnesses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    83K views2 pages

    GP 69 Form - Medical Examination

    Uploaded by

    Denley Kim
    This document is a medical examination form for candidates seeking temporary, contract, or permanent employment or an extension of their tour of duty with the Kenyan government. It consists of two parts: Part 1 is completed by the candidate's ministry or department and sends the candidate for a medical exam. Part 2 is completed by the examining medical officer and returned to the ministry with their determination of whether the candidate is fit for the intended employment. The form also includes notes on its completion and questions for the candidate to answer regarding any past hospitalizations, medical treatments, or illnesses.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    (To be completed in DUPLICATE)

    G.P. 69
    REPUBLIC OF KENYA
    _________
    PART I
    (Name and address of Ministry/Department)
    ..
    ..
    ..........................................
    To: The Medical Officer i/c .
    Name: *Mr/Miss/Mrs is sent herewith for medical examination as a
    candidate for *temporary/contract/permanent employment/fitness to extend tour by .. months
    (C.O.R. N.20 (1) as.. in this *Ministry/Department.
    .. (Signature)
    .. (Designation)
    Part 2
    CERTIFICATE OF MEDICAL EXAMINATION
    I HEREBY CERTIFY that I have this day examined the above named candidate and that in my
    opinion *he/she is *fit/unfit for *temporary/contract/permanent service/extension of tour by
    . Months (C.O.R. N20 (1)) as . in the Kenya
    Government Administration.
    .. Station
    .....Medical Officer
    ..............., 20
    Notes
    Part 1 of the form to be completed in duplicate by the officer sending the candidate for examination.
    Part 2 of the form to be completed by the Medical officer, who will return one copy to the
    Ministry/Department which sent the candidate.
    Particulars on reverse to be filled in by candidate before appearing for Medical Examination.
    *Delete whichever is inapplicable.

    Candidates full name (in BLOCL letters)

    The following questions to be answered by the candidate:


    1 have you ever been an in-patient in hospital or nursing home suffering from any disease or injury?
    If so, give dates, state nature of disease or injury, which hospital or nursing home. Name of
    doctor(s) who treated you and whether an operation was performed ....
    .
    .
    ..
    ..
    2 Apart from above, have you ever received medical treatment for any serious disease or injury? If
    so, give particulars.

    20

    Signature of Candidate
    ____
    GPK

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