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    G - P - 69 Form Medical

    Uploaded by

    Erick Amatta
    This document is a medical examination form (G.P. 69) for candidates seeking temporary, permanent, or extended employment in the Kenyan government. Part 1 is completed by the sending ministry/department with candidate details and the purpose of the medical exam. Part 2 is completed by the examining medical officer, certifying whether the candidate is fit or unfit for the intended employment based on the medical exam. Notes provide instructions on completing and distributing the duplicate form. The candidate also provides medical history details on the reverse.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    G - P - 69 Form Medical

    Uploaded by

    Erick Amatta
    796 views2 pages
    This document is a medical examination form (G.P. 69) for candidates seeking temporary, permanent, or extended employment in the Kenyan government. Part 1 is completed by the sending ministry/department with candidate details and the purpose of the medical exam. Part 2 is completed by the examining medical officer, certifying whether the candidate is fit or unfit for the intended employment based on the medical exam. Notes provide instructions on completing and distributing the duplicate form. The candidate also provides medical history details on the reverse.

    Original Description:

    G_P_69 form medical landscape format

    Original Title

    G_P_69 form medical

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    © © All Rights Reserved

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    This document is a medical examination form (G.P. 69) for candidates seeking temporary, permanent, or extended employment in the Kenyan government. Part 1 is completed by the sending ministry/department with candidate details and the purpose of the medical exam. Part 2 is completed by the examining medical officer, certifying whether the candidate is fit or unfit for the intended employment based on the medical exam. Notes provide instructions on completing and distributing the duplicate form. The candidate also provides medical history details on the reverse.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    796 views2 pages

    G - P - 69 Form Medical

    Uploaded by

    Erick Amatta
    This document is a medical examination form (G.P. 69) for candidates seeking temporary, permanent, or extended employment in the Kenyan government. Part 1 is completed by the sending ministry/department with candidate details and the purpose of the medical exam. Part 2 is completed by the examining medical officer, certifying whether the candidate is fit or unfit for the intended employment based on the medical exam. Notes provide instructions on completing and distributing the duplicate form. The candidate also provides medical history details on the reverse.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    G.P.

    69
    (To be completed in DUPLICATE)

    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/permanent employment/fitness to extend tour by.......................................................................
    Months (C.O.R. N.20 (1) as .......................................................................in this *Ministry/Departmen t.
    .............................................(Signature)
    ...........................................(Designation)
    PART 2
    CEERTIFICATE 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 N.20 (1)
    as.....................................................in the Kenya Government Administration
    ..................................................................Station .............................................................................
    Medical Officer
    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 ofn reverse to be filled in by candidate before appearing for Medical Examination
    *Delete whichever is inapplicable.
    Candidate’s full name (In BLOCK letters)..................................................................................................................... ..............
    The following question 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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