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Medical Certificate & Vision Check

Prepare a print-ready draft for your medical officer میڈیکل سرٹیفکیٹ اور نظر کی جانچ

Form B — Medical Certificate

Print the blank Form B below, attach a photograph and take it to a registered medical practitioner. فارم پرنٹ کریں اور رجسٹرڈ ڈاکٹر سے مکمل کروائیں۔

Note: every entry, including the CNIC number, must be handwritten by the certifying medical officer. The applicant must not write anything on this form.تمام فارم معہ شناختی کارڈ نمبر میڈیکل افسر تصدیق کنندہ کا قلمی ہونا ضروری ہے۔ درخواست دہندہ اس فارم پر کچھ لکھنے کا مجاز نہیں۔

At-home vision awareness check

Original color-dot number activities (not official Ishihara plates) and a basic near-vision reading exercise.

Board 1
Board 2
Board 3
Board 4
Board 5
Board 6

Near-vision reading check

At a comfortable reading distance, try reading each line without zooming. This is only a self-check.

E F P T O Z
L P E D C F
P E C F D Z P
F D P L T C E
These original, illustrative color activities are not Ishihara plates, are not clinically validated, and cannot diagnose color-vision deficiency. Screen appearance, device settings, and ambient light affect what you see. Do not use this as a substitute for an eye examination.

FORM B

(SEE SECTION 7(3) AND SECTION (2))

NATIONAL IDENTITY CARD NUMBER

Form of Medical Certificate in respect of application for a license to drive any transport vehicle or to drive any vehicle as paid employee or otherwise:

TO BE FILLED IN BY A REGISTERED MEDICAL PRACTITIONER

  1. What is apparent age of the applicant?
  2. Is the applicant; to best of your judgment subjected to epilepsy, vertigo, chronic ill-health likely to effect his/her efficiency?
  3. Does the applicant suffer from any heart or lung disorder which might effect the performance of his/her duties as a driver?
  4. (A) Is there any defect of sightedness, if so, has it been corrected by using suitable spectacles?(B) Does the applicant suffer from a degree of deafness which would prevent his/her hearing of ordinary sound signals?
  5. Does the applicant has any deformity or loss of members, Which effects the performance of his/her duties as a driver?
  6. Does the applicant possess any evidence of being addicted to the excessive use of alcohol tobacco or drugs?
  7. In your opinion; he/she is generally fit as regards (a) bodily in health, and(b) eyesight?
  8. Marks of identification.
  9. Blood Group

I certify that to the best of my knowledge and belief the applicant is the person here as above described and that the attached photograph is a reasonably correct likeness.

SPACE
FOR
PHOTOGRAPH
SIGNATURE
NAME
R.M.P NO.
DOCTOR'S NATIONAL IDENTITY CARD NO.
Date

(نوٹ) یہ تمام فارم معہ شناختی کارڈ نمبر میڈیکل افسر تصدیق کنندہ کا قلمی ہونا ضروری ہے۔
درخواست دہندہ اس فارم پر کچھ لکھنے کا مجاز نہیں۔

Print this Form B, attach a photograph and have it completed by a registered medical practitioner. Confirm current requirements with your licensing authority.

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