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Medical Form

The document is a letter from Rahul Chauhan informing Rakesh N Ranjan that he must undergo a pre-employment medical examination at an empaneled medical center. It provides instructions for Rakesh to schedule the examination at least one day in advance and fast for 12 hours prior. The letter also includes a list of tests to be performed and contact information for submitting results and bills. Rakesh will be reimbursed up to INR 1600 for medical expenses if the examination is not performed at an empaneled center.

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Rakesh Ranjan
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2K views3 pages

Medical Form

The document is a letter from Rahul Chauhan informing Rakesh N Ranjan that he must undergo a pre-employment medical examination at an empaneled medical center. It provides instructions for Rakesh to schedule the examination at least one day in advance and fast for 12 hours prior. The letter also includes a list of tests to be performed and contact information for submitting results and bills. Rakesh will be reimbursed up to INR 1600 for medical expenses if the examination is not performed at an empaneled center.

Uploaded by

Rakesh Ranjan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Ref: RCITPL/51682609/10697946/280317/2030

Rakesh N Ranjan

Dear Rakesh N Ranjan,

As a part of the recruitment process, we would request you to undergo a Pre-Employment Medical Examination.
These tests should be conducted at our empanelled medical centre. A list of tests to be conducted and the
empanelled medical centres are attached herewith for your reference. In case empanelled medical centre is not
available in your town, then you may get the medical test done from any reputed and authorized medical centre
in your town.

You are requested to take an appointment at the concerned Medical Centre for the Pre-Employment Medical
Examination at least a day in advance. You are also requested to fast for a minimum of 12 hours prior to the Pre-
Employment Medical Examination.

Empanelled Medical centres will send the reports and bills directly to us. In case of other medical centres, kindly
make the payment directly to the medical centre. You will be reimbursed the actual medical expenses incurred or
INR 1600.00/- (INR ONE THOUSAND SIX HUNDRED ONLY) whichever is lower.

Regards

Rahul Chauhan

[email protected]

Enclosed:
1. Letter for Pre-Employment Medical Check-up
2. Checklist
3. Pre-Employment Medical Check-up Form
4. Pre-Employment Medical Hospital List
Date: 28-Mar-17

Ref: RCITPL/51682609/10697946/280317/2030

To,
The Medical Officer,
Authorized Medical Centre

Sub: Pre- employment Medical Test

Dear Sir/ Madam,


We request you to do a pre-employment Medical Check-up of Rakesh N Ranjan (Candidate) as per the
given checklist and send the scanned copies of the reports (in one attachment) on
[email protected] and [email protected].

Please send the physical copy of reports to

Mr. Rahul Chauhan,


Work Station - 199,
TC 23,4th Floor,
Ghansoli - 400701

If you are empanelled with our company for pre-employment, payment will be done on credit basis.
Please send the bills on the below mentioned address:-

Dr. R Rajesh (Group Medical Advisor),


2nd floor, Maker Chamber -4,
222- Nariman Point,
Mumbai - 400021

If you are not empanelled with our company for pre-employment, then please collect the medical check-
up fees directly from candidate and handover the reports to the candidate.

Thanking you,

Reliance Corp IT Park Ltd

Specimen Signature of the Candidate


Checklist
1. Candidate's photograph is to be attested by the Medical Examiner
2. Fitness form is to be signed & stamped (Stamp with registration number) by the Medical
Examiner
3. List of the tests to be conducted are mentioned below:-
3.1. General physical examination, by a Registered Medical Practitioner having minimum
MBBS qualification
3.2. Eye examination by a qualified Ophthalmologist (Including Colour vision test
& Details of refractive error)
3.3. Complete Blood Count
3.4. Blood Sugar examination
3.5. Blood Group
3.6. Urine examination, routine and microscopic
3.7. X-ray chest
3.8. E. C. G.
3.9. SGPT
3.10. S. Bilirubin
3.11. S. Creatinine
3.12. S. Cholesterol
3.13. S. Triglyceride

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