Combined Medical Service Examination 2025

REGD. No. D. L.-33004/99 The Gazette of India CG-DL-E-24022025-261270 EXTRAORDINARY PART I-Section 1 PUBLISHED BY AUTHORITY No. 57] NEW DELHI, WEDNESDAY, FEBRUARY 19, 2025/MAGHA 30, 1946 1297 GI/2025 (1) MINISTRY OF HEALTH AND FAMILY WELFARE (Department of Health and Family Welfare) NOTIFICATION New Delhi, the 19th February, 2025 RULES No.A.12011/01/2025-CHS-I.—The rules for a Competitive Examination for the Combined Medical Services to be held by the Union Public Service Commission in 2025 for the purpose of filling vacancies in the following services/posts, are with the concurrence of Ministries/Departments concerned, Municipal Corporation of Delhi and New Delhi Municipal Council, published for general information: - Category-I Medical Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service Category-II (a) Assistant Divisional Medical Officer in the Railways. (b) General Duty Medical Officer in New Delhi Municipal Council. (c) General duty Medical Officer Gr-II in Municipal Corporation of Delhi. All candidates are requested to carefully read these Rules and the examination notice of the UPSC derived from these Rules. The examination will be conducted by the Union Public Service Commission in the manner prescribed in Appendix I to these Rules. The date(s) on which and the place(s) at which the examination will be held shall be fixed by the Commission. 2. A candidate may compete in respect of anyone or more of the services/posts mentioned above. A candidate will be required to indicate clearly in the Registration and Online Application Form the services/posts for which he/she wishes to be considered in the order of preferences. The candidate is advised to indicate his/her preferences as he/she wishes so that having regard to his/her rank in order of merit due consideration can be given to his/her preferences while making appointments. While indicating preference a candidate shall have to indicate choice between Category I and Category II first duly keeping in view the eligibility for the two categories of posts/services in terms of Rule 5(a)&(b) below. Subsequently the candidate will also indicate preferences among services/ posts of Category II. In case preference for none of the Services is indicated, the candidate will not be considered for Service Allocation. Candidates will be recommended by the Commission based on the preference of categories given by them in the Registration and Online Application Form, order of merit and number of vacancies. 3. (i) Candidates are advised to examine their eligibility for both categories carefully while exercising preferences of categories and services in terms of Rules 5(a)&(b). (ii) Once cadre has been allocated to a candidate, no request for change of cadre shall be entertained by the Commission/Ministry of Health & Family Welfare. The number of vacancies to be filled on the basis of results of the examination will be specified in the Notice issued by the Commission. Reservation will be made for candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability in respect of vacancies as may be fixed by the Government. 4. A candidate be either: (i) a citizen of India, or (ii) a subject of Nepal, or (iii) a subject of Bhutan, or (iv) a Tibetan refugee who came over to India before the 1st January, 1962 with the intention of permanently settling in India; or (v) a person of Indian origin who has migrated from Pakistan, Burma, Sri Lanka or East African Countries of Kenya, Uganda, The United Republic of Tanzania, Zambia, Malawi, Zaire and Ethiopia or from Vietnam with the intention of permanently settling in India: Provided that a candidate belonging to categories (ii), (iii), (iv) and (v) above shall be a person in whose favour a certificate of eligibility has been issued by the Government of India. A candidate in whose case a certificate of eligibility is necessary, may be admitted to the examination but the offer of appointment may be given only after the necessary eligibility certificate has been issued to him by the Government of India. 5. (a) A candidate for this examination must not have attained the age of 32 years as on 1st August, 2025 i.e. he must have been born not earlier than 2nd August, 1993. However, for Medical Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service, the upper age limit must not exceed 35 (thirty five years) as on 1st August, 2025. (b) The upper age- limit is relaxable as follows: (i) Up to a maximum of five years if a candidate belongs to a Scheduled Caste or a Scheduled Tribe. (ii) Up to a maximum of three years in the case of candidate belonging to Other Backward Classes who are eligible for reservation applicable to such candidates. (iii) Up to a maximum of three years in the case of Defence Services Personnel, disabled in operations during hostilities with any foreign country or in a disturbed area and released as a consequence thereof. (iv) Up to a maximum of five years in the case of Ex-servicemen including Commissioned Officers and ECOs/SSCOs who have rendered at least five years Military Service as on 1st August, 2025 and have been released (i) on completion of assignment (including those whose assignment is due to be completed within one year from 1st August, 2025 otherwise than by ways of dismissal or discharge on account of misconduct of inefficiency), or (ii) on account of physical disability attributable to Military Service or (iii) on invalidment. (v) Up to a maximum of five years in the case of ECOs/SSCOs who have completed an initial period of assignment of five years of Military Service as on 1st August, 2025 and whose assignment has been extended beyond five years and in whose case the Ministry of Defence issues a certificate that they can apply for Civil Employment and that they will be released on three months' notice on selection from the date of receipt of offer of appointment. (vi) Up to a maximum of ten years in the case of Persons with Benchmark Disability viz. (a) blindness and low vision, (b) deaf and hard of hearing, (c) Locomotor disability including cerebral palsy, leprosy cured, dwarfism, acid attack victims and muscular dystrophy, (d) autism, intellectual disability, specific learning disability and mental illness; (e) multiple disabilities from amongst person under clauses (a) to (d) of Section 34 of the Rights of Persons with Disabilities Act, 2016 including deaf-blindness. Note I- Candidates belonging to the Scheduled Castes, the Scheduled Tribes and the Other Backward Classes who are also covered under any other clauses of Rule 5 (b) above, viz. those coming under the category of Ex-servicemen, and Persons with Benchmark Disability will be eligible for grant of cumulative age-relaxation under both the categories. Note II- The details of Functional Classification (FC) and Physical Requirements (PR) of each service are indicated in Appendix IV of these Rules which are identified and prescribed by the respective Cadre Controlling Authorities (CCAs) as per the provisions of Section 33 and 34 of the Rights of Persons with Disabilities Act, 2016. Only those category (ies) of disability (ies) mentioned in Appendix IV shall apply for the examination under Persons with Benchmark Disability (PwBD) Category. Therefore, the candidates belonging to the Persons with Benchmark Disability categories are advised to read it carefully before applying for the examination. Note III- The term Ex-servicemen will apply to the persons who are defined as Ex-servicemen in the Ex-servicemen (Re-employment in Civil Services and Posts) Rules, 1979, as amended from time to time. Note IV- The age concession under Rule 5(b) (iv) and (v) will be admissible to Ex-servicemen i.e. a person who has served in any rank whether as combatant or non-combatant in the Regular Army, Navy and Air Force of the Indian Union and who either has been retired or relieved or discharged from such service whether at his own request or being relieved by the employer after earning his or her pension. Note V- Notwithstanding the provision of age-relaxation under Rule 5(b)(vi) above, a Person with Benchmark Disability will be considered to be eligible for appointment only if he/she after such physical examination as the Government or appointing authority, as the case may be, may prescribe is found to satisfy the requirements of physical and medical standards for the concerned Services/Posts to be allocated to the Persons with Benchmark Disability by the Government. SAVE AS PROVIDED ABOVE THE AGE LIMITS PRESCRIBED CAN IN NO CASE BE RELAXED (c) The date of birth accepted by the Commission is that entered in the Matriculation or Secondary School Leaving Certificate or in a certificate recognised by an Indian University as equivalent to Matriculation or in an extract from a Register of Matriculates maintained by a University which must be certified by the proper authority of the University or in the Higher Secondary or an equivalent examination certificate. No other document relating to age like horoscopes, affidavits, birth extracts from Municipal Corporation, Service records and the like will be accepted. The Expression Matriculation/Higher Secondary Examination Certificate in this Part of the instructions includes the alternative certificates mentioned above. Note 1:- Candidates should note that only the date of birth as recorded in the Matriculation/ Secondary Examination Certificate or an equivalent certificate on the date of submission of application will be accepted by the Commission and no subsequent request for its change will be considered or granted. Note 2:- Candidates should also note that once a date of birth has been submitted by them in the Registration and Online Application Form and entered in the records of the Commission for the purpose of admission to an Examination, no change will be allowed subsequently or at any other Examination of the Commission on any ground whatsoever. 6. A candidate must have passed the written and practical part of the final M.B.B.S. Examination. Note 1: A candidate who has appeared/or is yet to appear at the final M.B.B.S. Examination may also apply. Such candidates will be admitted to the examination if otherwise eligible but the admission would be deemed to be provisional subject to cancellation, if they do not produce proof of having passed the written and practical parts of the final M.B.B.S. Examination within the time limit prescribed in Rule 9(a)(ii) below. Only valid proof of passing the qualifying examination viz. Degree Certificate/Final Marksheet/Provisional Degree Certificate etc. as are normally issued to the candidates by the competent authority will be accepted. Note 2: A candidate who has yet to complete the compulsory rotating internship is educationally eligible for admission to the examination but on selection he/she will be appointed only after he/she has completed the compulsory rotating internship. 7. Candidates must pay the fee prescribed in the Commission's Notice. 8. All candidates in Government service, whether in permanent or temporary capacity or as work charged employees other than casual or daily rated employees or those serving under the Public Enterprises are however, required to submit an undertaking that they have informed in writing their Head of Office/Department that they have applied for the examination. Candidates should note that in case a communication is received from their employer by the Commission withholding permission to the candidates applying for/ appearing at the examination their application shall be rejected/candidature shall be cancelled. 9. The decision of the Commission with regard to the acceptance of the application of a candidate and his/her eligibility or otherwise for admission to the examination shall be final. The candidates applying for the examination should ensure that they fulfil all the eligibility conditions for admission to the Examination. Their admission at all the stages of examination for which they are admitted by the Commission viz. Written Examination and Interview Test will be purely provisional subject to their satisfying the prescribed eligibility conditions. If on verification at any time before or after the Written Examination or Interview Test, it is found that they do not fulfil any of the eligibility conditions; their candidature for the examination will be cancelled by the Commission. 9(a) Registration and Online Application Form: 9(a)(i) A candidate who is willing to apply for Combined Medical Services Examination shall be required to apply on-line and submit the requisite information and supporting documents towards various claims, such as date of birth, category [viz. SC/ST/OBC/ EWS/PwBD/Ex-Servicemen], educational qualification, etc. as may be sought by the Commission alongwith the Registration and Online Application Form. For detailed instructions for filling up the form, the Notice for Combined Medical Services Examination, 2025 may be referred. The failure to provide the required information/documents alongwith the Registration and Online Application Form, will entail cancellation of candidature for the examination. 9(a)(ii) The Commission shall provide a window of 15 (Fifteen) days from the date of declaration of result of written part of Combined Medical Services Examination to the candidates qualified for Personality Test/Interview. The candidates as per Note 1 below Rule 6 shall be required to update their details/educational qualification status (whether appearing/appeared) and to produce/upload the proof of passing of the written and practical parts of the final M.B.B.S. Examination at the specified module/portal, failing which such candidates will not be allowed to appear in the Personality Test/Interview and his/her candidature will be liable to be cancelled. Note: In this period, all the candidates qualified for Personality Test shall also be provided an option to update Correspondence/Permanent Postal Address, Higher Educational Qualification, Achievement in different field (if any), Employment Details/Service Experience, Service Allocation, Service Preferences (if qualified for both the categories of posts). The details updated in this window will be treated as final and no request for any change in these fields received through any other mode will be entertained. 10. No candidate shall be admitted to the examination unless he/she holds a certificate of admission from the Commission. 11(1). A candidate who is or has been declared by the Commission to be guilty of:- (a) obtaining support for candidature by the following means, namely:- (i) offering illegal gratification to; or (ii) applying pressure on; or (iii) blackmailing or threatening to blackmail any person connected with the conduct of the examination; or (b) impersonation; or (c) procuring impersonation by any person; or (d) submitting fabricated / incorrect documents or documents which have been tampered with; or (e) uploading irrelevant or incorrect photo/ signature in the application form in place of actual photo/signature; or (f) making statements which are incorrect or false or suppressing material information; or (g) resorting to the following means in connection with the candidature for the examination, namely :- (i) obtaining copy of question paper through improper means; or (ii) finding out the particulars of the persons connected with secret work relating to the examination; or (iii) influencing the examiners; or (h) being in possession of or using unfair means during the examination; or (i) writing obscene matter or drawing obscene sketches or irrelevant matter in the scripts; or (j) misbehaving in the examination hall including tearing of the scripts, provoking fellow examinees to boycott examination, creating a disorderly scene and the like; or (k) harassing, threatening or doing bodily harm to the staff employed by the Commission for the conduct of the examination; or (1) being in possession of or using any mobile phone (even in switched-off mode) pager or any electronic equipment or programmable device or storage media like pen drive, smart watches etc or camera or bluetooth devices or any other equipment or related accessories (either in working or switched-off mode) capable of being used as a communication device or during the examination; or (m) violating any of the instructions issued to candidates along with their admission certificates permitting them to take the examination; or (n) attempting to commit or, as the case may be, abetting the commission of all or any of the acts specified in the foregoing clauses; In addition to being liable to criminal prosecution, shall be disqualified by the Commission from the Examination held under these Rules; and/or shall be liable to be debarred either permanently or for a specified period:- (i) by the Commission, from any examination or selection held by them; (ii) by the Central Government from any employment under them; and shall be liable to face disciplinary action under the appropriate rules if already in service under Government; Provided that no penalty under this rule shall be imposed except after:- (i) giving the candidate an opportunity of making such representation in writing as the candidate may wish to make in that behalf; and (ii) taking the representation, if any, submitted by the candidate within the period allowed for this purpose, into consideration. (2) Any person who is found by the Commission to be guilty of colluding with a candidate(s) in committing or abetting the commission of any of the misdeeds listed at the clauses (a) to (m) above will be liable to action in terms of the clause (n) above. 12. Candidates who obtain such minimum qualifying, marks in the written examination as may be fixed by the Commission in their discretion shall be summoned by them for an interview for a personality test: Provided that candidates belonging to the Scheduled Castes or the Scheduled Tribes or the Other Backward Classes or Economically Weaker Sections or Persons with Benchmark Disability may be summoned for an interview for personality test by the Commission by applying relaxed standards if the Commission are of the opinion that sufficient number of candidates from these communities are not likely to be summoned for interview for personality test on the basis of the general standard in order to fill up the vacancies reserved for them. 13. (1) After interview the Commission will prepare two separate merit lists - one for Category I i.e. the Medical Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service and the other for Category II i.e. Non-CHS (viz. Ministry of Railways, New Delhi Municipal Council, Municipal Corporation of Delhi) on the basis of the ranks/preferences of the candidates and vacancies. For preparation of result, the candidates shall be arranged by the Commission in the order of merit on the basis of aggregate marks finally awarded to each candidate in the Examination. Thereafter, the Commission, based on the preference exercised by the candidates, shall recommend candidates to both Categories in order of respective merit for each category. The Commission shall for the purpose of recommending candidates against unreserved vacancies, fix separate qualifying marks (hereinafter referred to as general qualifying standards) with reference to the number of unreserved vacancies to be filled up in CHS and other remaining Services/Posts on the basis of the Examination. For the purpose of recommending reserved category candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, the Economically Weaker Sections and Persons with Benchmark Disability against reserved vacancies the Commission may relax the qualifying standards with reference to number of reserved vacancies to be filled up in each of these categories on the basis of the examination. Provided that the candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, the Economically Weaker Sections and Persons with Benchmark Disability who have not availed themselves of any of the concessions or relaxations in the eligibility or selection criteria, at any stage of the Examination and who after taking into account the general qualifying standards are found fit for recommendation by the Commission shall not be recommended against the vacancies reserved for the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability but shall in the first instance be recommended by the Commission against the unreserved vacancies. Note: The facility of scribe alongwith compensatory time which is available for eligible candidates belonging to PwBD category and the disability of such candidates which he is suffering from in respect of Medical Fitness, shall not be treated as relaxation/concession. (2) While making service allocation for the Services/posts in Category II the candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability recommended against unreserved vacancies may be adjusted against reserved vacancies by the Government if by this process they get a service of higher choice in the order of their preference. (3) For preparation of the merit list for the services/posts in Category II, the Commission may further lower the general qualifying standards to take care of any shortfall of candidates for appointment against resultant unreserved vacancies and any surplus of candidates against reserved vacancies arising out of the process as per provisions of this rule, the Commission may make the recommendations in the manner prescribed in sub-rules (4) and (5). (4)(a)(1) While recommending the candidates for the services/posts in Category-II the Commission shall in the first instance, take into account the total number of vacancies of Category-II only. This total number of recommended candidates shall be reduced by the number of candidates belonging to the Scheduled Castes, the Scheduled Tribes, the Other Backward Classes, Economically Weaker Sections and Persons with Benchmark Disability who acquire the merit at or above the fixed general qualifying standards for these services/posts without availing themselves of any concession or relaxation in the eligibility or selection criteria in terms of the proviso to sub-rule (1). (4)(a)(2) While exercising the method defined in sub-rule (4)(a)(1), due consideration may be taken to secure the vacancy(ies) for PwBD candidates expected to be recommended from Reserve List and if required, the total number of recommended candidates shall be reduced appropriately in addition to reduction as per sub-rule (4)(a)(1). (4)(b) Along with this list of recommended candidates for the services/posts in Category-II only, the Commission shall also maintain a consolidated reserve list of candidates which will include candidates from unreserved, reserved categories and PwBD category, ranking in order of merit below the last recommended candidate under each category. The consolidated reserve list so maintained shall be treated as confidential till the process of recommendation(s) in term of sub-rule (5) is finally concluded by the Commission. The number of candidates in each of these categories will be equal to the number of reserved category candidates who were included in the first list without availing of any relaxation or concession in eligibility or selection criteria as per proviso to sub-rule(1) and reduction in recommendation against unreserved vacancy(ies), if any, in light of sub-rule (4)(a)(2). (4)(c) The number of reserved category in the Consolidated Reserve List, from each category of Schedule Caste, Schedule Tribe, Other Backward Class, Economically Weaker Section and Persons with Benchmark Disability will be equal to the Respective number of candidates reduced in each category while recommending candidates in the first instance as per sub-rule 4(a)(1) and 4(a)(2). (5) The candidates recommended in terms of the provisions of sub-rule (4), shall be allocated by the Government to the services/posts in Category-II and where certain vacancies still remain to be filled up, the Government may forward a requisition to the Commission requiring it to recommend, in order of merit from the reserve list, the same number of candidates as requisitioned for the purpose of the unfilled vacancies in each category. Note: Reserve list is not a waiting list to cater to vacancies arising out of other reasons such as candidates not turning up to join, being found medically unfit, left out on account of medical fitness for limited services, resignation or any other reasons. Commission will not take into account such vacancies for release of Reserve list. (6) No consolidated reserve list will be maintained by the Commission for Category-I as the provisions of sub-rule (2), (3), (4) and (5) above are not applicable for allocation of candidates to Category-I. 14. The minimum qualifying marks as specified under rules 11 and 12 may be relaxable at the discretion of the Commission in favour of Persons with Benchmark Disability in order to fill up the vacancies reserved for them. 15. The form and manner of communication of the result of the examination to individual candidates shall be decided by the Commission in their discretion and the Commission will not enter into correspondence with them regarding the results. 16. Subject to other provisions contained in these rules, successful candidates will be considered for appointment on the basis of the order of merit assigned to them by the Commission and preference expressed by them for various posts. 17. Success in the examination confers no right to appointment unless Government are satisfied after such enquiry as may be considered necessary that the candidate with regard to his/her character and antecedents is suitable in all respects for appointment to the service. The appointment will be further subject to the candidate satisfying the appointing authority of his/her having satisfactorily completed the compulsory rotating internship. 18. A candidate must be in good mental and bodily health and free from any physical defects likely to interfere with the discharge of his/her duties as an officer of the Service. A candidate who after such physical examination, as Government or the appointing authority, as the case may be prescribe is found not to satisfy these requirements will not be appointed. The Regulations relating to Physical/Medical Examination of candidates are given in Appendix-III to these Rules. A Medical Board Report Format for medical examination is given at Appendix – VIII. All candidates who qualify for interview/personality test on the basis of written part of the examination shall be required to undergo the medical examination normally on the next working day immediately after the day of interview/ personality test of the concerned candidate (there shall be no medical examination on Saturdays, Sundays and closed holidays). Arrangements for the complete medical examination including X-Ray of chest of candidates will be made by the Ministry of Health and Family Welfare, Nirman Bhawan, New Delhi and intimation in this regard shall be given by the Ministry to the concerned candidates. In case a candidate does not receive any intimation about the arrangements made for his/her Medical Examination before he/she leaves for his/her interview/personality test he/she should contact personally to the concerned authority in Ministry of Health and Family Welfare immediately after his/her interview/personality test is over. The concerned candidate may have to stay in Delhi until his/her Medical Examination is over, therefore the candidate should take this fact in consideration and make his/her own arrangements for stay in Delhi for the purpose of completion of Medical Examination formality. No extension postponement of the date fixed for the Medical Examination shall be allowed under any circumstances. Also no TA/DA shall be admissible for the purpose of completion of the formality of Medical Examination of the concerned candidate. To be passed as fit for appointment, a candidate must be in good mental and bodily health and free from any physical defect likely to interfere with the discharge of his duties as an officer of the service. A candidate, who after such medical examination as Government or the appointing authority, as the case may be, may prescribe, is found not to satisfy these requirements will not be appointed. A candidate who has been left out on account of medical fitness for limited services and no vacancy being available at his turn cannot be allocated to any service for which he is not fit and where vacancies exists. Candidates declared medically unfit as per medical standards specified in Appendix – III will be left out from the allocation process. 19. For being considered against the vacancies reserved for them the Persons with Benchmark Disability should have disability of forty per cent (40%) or more. However, such candidates shall be required to meet one or more of the physical requirements/abilities indicated in Appendix – IV which may be necessary for performing the duties in the concerned Services/Posts. 20. The eligibility for availing reservation against the vacancies reserved for the Persons with Benchmark Disability shall be the same as prescribed in "The Rights of Persons with Disabilities Act, 2016". The candidates of Multiple Disabilities will be eligible for reservation under category (e) - Multiple Disabilities only of Section 34(1) of RPwD Act, 2016 and shall not be eligible for reservation under any other categories of disabilities i.e. (a) to (d) of Section 34(1) of RPwD Act, 2016 on account of having 40% and above impairment in any of these categories of PwBD. Provided further that the Persons with Benchmark Disability shall also be required to meet special eligibility criteria in terms of Functional Classification and Physical Requirements (abilities/disabilities) (FC&PR) consistent with requirements of the identified service/post as may be prescribed by its Cadre Controlling Authority. A list of services identified suitable for Persons with Benchmark Disability alongwith the Functional Classification and Physical Requirements is at Appendix IV. 21. A candidate will be eligible to get the benefit of community reservation only in case the particular caste to which the candidates belongs is included in the list of reserved communities issued by the Central Government. The candidates will be eligible to get the benefit of the Economically Weaker Section reservation only in case the candidate meets the criteria issued by the Central Government and in possession of such eligibility certification. The OBC candidates applying for Combined Medical Services Examination, 2025 must produce OBC (Non- Creamy Layer) certificate based on the Income for the Financial Year (FY) 2021-2022, 2022-2023 and 2023-2024 and issued on/after 01.04.2024 (after the completion of FY 2023-24) but not later than the closing date of the application for Combined Medical Services Examination-2025 i.e. 11.03.2025. If a candidate indicates in his/her Online Application Form for Combined Medical Service Examination that he/she belongs to Unreserved Category but subsequently writes to the Commission to change his/her category, to a reserved one, such request shall not be entertained by the Commission. Further, once a candidate has chosen a reserved category, no request shall be entertained for change to other reserved category viz. SC to ST, ST to SC, OBC to SC/ST or SC/ST to OBC. SC to EWS, EWS to SC, ST to EWS, EWS to ST, OBC to EWS, EWS to OBC. No reserved category candidates other than those who qualified each stage of the Examination on General standard shall be allowed to change (on their request or as decided by the Commission/Government based on the documents submitted by them) their category from reserved to unreserved or claim the vacancies (Service/Cadre) for unreserved category after the declaration of final result by UPSC. In cases where such candidates do not qualify on General Standard, their candidature shall be cancelled. Further, no Person with Benchmark Disabilities (PwBD) of any sub-category there under shall be allowed to change his/her sub-category of disability. While the above principle will be followed in general, there may be a few cases where there was a gap not more than 3 months between the issuance of a Government Notification enlisting a particular community in the list of any of the reserved communities and the date of submission of the application by the candidate. In such cases the request of change of community from general to reserved may be considered by the Commission on merit. In case of a candidate unfortunately becoming persons with benchmark disability during the course of the examination process, the candidate should produce valid document showing him acquiring a disability to the extent of 40% or more as defined under the RPwD Act, 2016 to enable him to get the benefits of PwBD reservation. 22. Candidates seeking reservation/relaxation benefits available for SC/ST/OBC/EWS/PwBD/Ex-servicemen must ensure that they are entitled to such reservation/relaxation as per eligibility prescribed in the Rules/Notice. They should be in possession of all the requisite certificates in the prescribed format in support of their claims as stipulated in the Rules/Notice for such benefits, by the closing date of the application for Combined Medical Services Examination, 2025. (Prescribed Format of Disability Certificate should be submitted by Persons with Benchmark Disability candidates as per Form V to Form VII (as applicable) of Min of Social Justice and Empowerment Notification dated 15th June, 2017 as at Annexure-III). A candidate of Combined Medical Services Examination, 2025 will be eligible to get the benefit of the Economically Weaker Section reservation only in case the candidate meets the criteria issued by the Central Government and is in possession of requisite Income & Asset Certificate based on the income for Financial Year (FY) 2023-2024 and issued on/after 01.04.2024 (after the completion of FY 2023-24) but not later than the closing date of the application for Combined Medical Services Examination-2025 i.e. 11.03.2025. 23. No person,- (a) Who has entered into or contracted a marriage with a person having a spouse living; or (b) Who having a spouse living has entered into or contracted a marriage with any person; shall be eligible for appointment to service: Provided that the Central Government may, if satisfied that such marriage is permissible under the personal law applicable to such person and the other party to the marriage and there are other grounds for so doing, exempt any person from the operation of this rule. 24. Brief particulars relating to the Services/Posts to which recruitment is being made through this examination are given in Appendix II. APPENDIX-I SCHEME OF EXAMINATION The examination shall be conducted according to the following plan:- Part-I WRITTEN EXAMINATION – (500 marks) The candidates will take the written examination in two Papers, each Paper carrying a maximum of 250 marks. Each Paper will be of two hours duration. Part-II PERSONALITY TEST: (100 Marks): Personality test carrying 100 marks of such of the candidates who qualify on the results of the written examination. (A) WRITTEN EXAMINATION: 1. The components and syllabi of two Papers and the weightage to different components in the two papers are given below: Paper I (Code No. 1) General Medicine and Paediatrics: Maximum Marks: 250 Total questions in Paper I = 120 (96 from General Medicine and 24 from Paediatrics); SYLLABUS OF PAPER-I (a) General Medicine including the following: (i) Cardiology (ii) Respiratory diseases (iii) Gastro-intestinal (iv) Genito-Urinary (v) Neurology (vi) Hematology (vii) Endocrinology (viii) Metabolic disorders (ix) Infections/Communicable Diseases a) Virus b) Rickets c) Bacterial d) Spirochetal e) Protozoan f) Metazoan g) Fungus (x) Nutrition/Growth (xi) Diseases of the skin (Dermatology) (xii) Musculoskelatal System (xiii) Psychiatry (xiv) General (xv) Emergency Medicine (xvi) Common Poisoning (xvii) Snake bite (xviii) Tropical Medicine (xix) Critical Care Medicine (xx) Emphasis on medical procedures (xxi) Patho physiological basis of diseases (xxii) Vaccines preventable diseases and Non vaccines preventable diseases (xxiii) Vitamin deficiency diseases (xxiv) In psychiatry include – Depression, psychosis, anxiety, bipolar diseases and Schizoprenia. (b) Paediatrics including the following - (i) Common childhood emergencies, (ii) Basic new born care, (iii) Normal developmental milestones, (iv) Accidents and poisonings in children, (v) Birth defects and counseling including autism, (vi) Immunization in children, (vii) Recognizing children with special needs and management, and (viii) National programmes related to child health. Paper II (Code No. 2) (a) Surgery Maximum Marks: 250 (b) Gynaecology & Obstetrics (c) Preventive & Social Medicine Total questions in Paper II = 120 (40 questions from each part.) SYLLABUS OF PAPER - II (a) SURGERY (Surgery including ENT, Ophthalmology, Traumatology and Orthopaedics) (I) General Surgery i) Wounds ii) Infections iii) Tumours iv) Lymphatic v) Blood vessels vi) Cysts/sinuses vii) Head and neck viii) Breast ix) Alimentary tract a) Oesophagus b) Stomach c) Intestines d) Anus e) Developmental x) Liver, Bile, Pancreas xi) Spleen xii) Peritoneum xiii) Abdominal wall xiv) Abdominal injuries (II) Urological Surgery (III) Neuro Surgery (IV) Otorhinolaryngology E.N.T. (V) Thoracic surgery (VI) Orthopedic surgery (VII) Ophthalmology (VIII) Anesthesiology (IX) Traumatology (X) Diagnosis and management of common surgical ailments (XI) Pre-operative and post operative care of surgical patients (XII) Medicolegal and ethical issues of surgery (XIII) Wound healing (XIV) Fluid and electrolyte management in surgery (XV) Shock patho-physiology and management. (b) GYNAECOLOGY & OBSTETRICS (I) OBSTETRICS i) Ante-natal conditions ii) Intra-natal conditions iii) Post-natal conditions iv) Management of normal labours or complicated labour (II) GYNAECOLOGY i) Questions on applied anatomy ii) Questions on applied physiology of menstruation and fertilization iii) Questions on infections in genital tract iv) Questions on neoplasma in the genital tract v) Questions on displacement of the uterus vi) Normal delivery and safe delivery practices vii) High risk pregnancy and management viii) Abortions ix) Intra Uterine growth retardation x) Medicolegal examination in obgy and Gynae including Rape. (III) FAMILY PLANNING i) Conventional contraceptives ii) U.D. and oral pills iii) Operative procedure, sterilization and organization of programmes in the urban and rural surroundings iv) Medical Termination of Pregnancy (c) PREVENTIVE SOCIAL AND COMMUNITY MEDICINE I Social and Community Medicine II Concept of Health, Disease and Preventive Medicine III Health Administration and Planning IV General Epidemiology V Demography and Health Statistics VI Communicable Diseases VII Environmental Health VIII Nutrition and Health IX Non-communicable diseases X Occupational Health XI Genetics and Health XII International Health XIII Medical Sociology and Health Education XIV Maternal and Child Health XV National Programmes XVI Management of common health problems XVII Ability to monitor national health programmes XVIII Knowledge of maternal and child wellness XIX Ability to recognize, investigate, report, plan and manage community health problems including malnutrition and emergencies. 2. The written examination in both the papers will be completely of objective (Multiple choice answers) type. The question Papers (Test Booklets) will be set in English only. 3. General Instructions for Examination: 3.1 Candidates must write the papers in their own hand. In no circumstances will they be allowed the help of a scribe to mark the answers for them. However, the Persons with Benchmark Disabilities in the categories of blindness, locomotor disability (both arm affected-BA) and cerebral palsy will be eligible for the facility of scribe. In case of other category of Persons with Benchmark Disabilities as defined under section 2(r) of the RPwD Act, 2016, such candidates will be eligible for the facility of scribe on production of a certificate to the effect that the person concerned has physical limitation to write, and scribe is essential to write examination on his/her behalf, from the Chief Medical Officer/Civil Surgeon/ Medical Superintendent of a Government Health Care institution as per proforma at Appendix-V. Further, for persons with specified disabilities covered under the definition of Section2(s) of the RPwD Act, 2016 but not covered under the definition of Section 2 (r) of the said Act, i.e. persons having less than 40% disability and having difficulty in writing will be provided the facility of scribe subject to production of a certificate to the effect that person concerned has limitation to write and that scribe is essential to write examination on his/her behalf from the competent medical authority of a Government healthcare institution as per proforma at Appendix – VII. 3.2 The candidates have discretion of opting for his/her own scribe or request the Commission for the same. The details of scribe i.e. whether own or the Commission's and the details of scribe in case candidates are bringing their own scribe, will be sought at the time of filling up the Online Application Form as per proforma at Appendix VI (for Candidate having 40% disability or more) and Appendix – IX (for Candidate having less than 40% disability and having difficulty in writing). 3.3 The qualification of the Commission's scribe as well as own scribe will not be more than the minimum qualification criteria of the examination. However, the qualification of the scribe should always be matriculate or above. 3.4 The Persons with Benchmark Disabilities in the category of blindness, locomotor disability (both arm affected-BA) and cerebral palsy will be eligible for Compensatory Time of twenty minutes per hour of the examination. In case of other categories of Person with Benchmark Disabilities, such candidates will be eligible for this facility on production of a certificate to the effect that the person concerned has physical limitation to write from the Chief Medical Officer/Civil Surgeon/ Medical Superintendent of a Government Health Care institution as per proforma at Appendix - V. Further, for persons with specified disabilities covered under the definition of Section 2(s) of the RPwD Act, 2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having less than 40% disability and having difficulty in writing will be provided compensatory time subject to production of a certificate to the effect that person concerned has limitation to write and that scribe is essential to write examination on his/her behalf from the competent medical authority of a Government healthcare institution as per proforma at Appendix-VII. 3.5 Facility of Scribe and/or Compensatory time in eligible candidate will be provided, if desired by them. Note (1): The eligibility conditions of a scribe, his/her conduct inside the examination hall and the manner in which and extent to which he/she can help the eligible candidate (as defined above) in writing the Combined Medical Services Examination shall be governed by the instructions issued by the UPSC in this regard. Violation of all or any of the said instructions shall entail the cancellation of the candidature of candidate in addition to any other action that the UPSC may take against the scribe. Note (2): The criteria for determining the percentage of visual impairment shall be as follows :- +---------------+---------------+-------------+--------------------+ | Better eye | Worse eye | Per Cent | Disability category| | Best Corrected| Best Corrected| Impairment | | +---------------+---------------+-------------+--------------------+ | | 6/6 to 6/18 | 0% | 0 | | | 6/24 to 6/60 | 10% | 0 | | 6/6 to 6/18 | Less than 6/60| 20% | I | | | to 3/60 | | | | | Less than 3/60| 30% | II (One eyed person)| | | to No Light | | | | | Perception | | | +---------------+---------------+-------------+--------------------+ | 6/24 to 6/60 | 6/24 to 6/60 | 40% | III a (low vision) | | Or | Less than 6/60| 50% | III b (low vision) | | Visual field | to 3/60 | | | | less than 40 | Less than 3/60| 60% | III c (low vision) | | up to 20 | to No Light | | | | degree around | Perception | | | | centre of | | | | | fixation or | | | | | heminaopia | | | | | involving | | | | | macula | | | | +---------------+---------------+-------------+--------------------+ | Less than 6/60| Less than 6/60| 70% | III d (low vision) | | to 3/60 | to 3/60 | | | +---------------+---------------+-------------+--------------------+ | Less than 3/60| Less than 3/60| 80% | III e (low vision) | | to 1/60 | to No Light | | | | Or | Perception | | | | Visual field | | | | | less than 10 | | | | | degree around | | | | | centre of | | | | | fixation | | | | +---------------+---------------+-------------+--------------------+ | Only HMCF | Only HMCF | 90% | IV a (Blindness) | | Only Light | Only Light | | | | Perception | Perception | | | | No Light | No Light | | | | Perception | Perception | | | +---------------+---------------+-------------+--------------------+ | | | 100% | IV b (Blindness) | +---------------+---------------+-------------+--------------------+ Note (3): The concession admissible to blind/low vision candidates shall not be admissible to those suffering from Myopia. 4. The Commission have discretion to fix qualifying marks in any or both the papers of the examination. 5. Penalty for wrong answers There will be penalty (Negative Marking) for wrong answers marked by a candidate in the objective type question papers. (i) There are four alternatives for the answers to every question. For each question for which a wrong answer has been given by the candidate, one third of the marks assigned to that question will be deducted as penalty. (ii) If a candidate gives more than one answer, it will be treated as a wrong answer even if one of the given answers happens to be correct and there will be same penalty as above for that question. (iii) If a question is left blank i.e. no answer is given by the candidate, there will be no penalty for that question. 6. Candidates are not permitted to use calculators for answering objective type papers. They should, therefore not bring the same inside the Examination Hall. 7. Both the Papers of the CMSE will be of MBBS standard. (B) PERSONALITY TEST – (100 marks): Candidates who qualify in the written examination will be called for Interview/ Personality Test to be conducted by the Union Public Service Commission. The Interview/ Personality Test will carry 100 marks. The Interview for Personality Test will be intended to serve as a supplement to the written examination for testing the General Knowledge and ability of the candidates in the fields of their academic study and also in the nature of a personality test to assess the candidate's intellectual curiosity, critical powers of assimilation, balance of judgement and alertness of mind, ability for social cohesion, integrity of character, initiative and capability for leadership. APPENDIX-II Brief particulars relating to the services/posts to which recruitment is being made through this examination are given below:- I. Assistant Divisional Medical Officer in the Railways: (a) The post of Assistant Divisional Medical Officer in the Indian Railway Health Service is in Group 'A" Junior Scale in level 10 of Pay Matrix Rs. 56100-177500/- and it carries Non-Practising Allowance as per rules/orders in force from time to time. Private practice is prohibited. The candidate will be bound to observe the orders which the Ministry of Railways or any other competent authority may issue from time to time restricting or prohibiting private practice by him/her. (b) A candidate will be appointed on probation for a period of one year which may be extended by the Government if considered necessary. On satisfactory completion of the probation candidates will be eligible for confirmation in the junior scale of the Indian Railway Health Service. (c) The appointment of probationers can be terminated by one month's notice in writing on either side during the period of probation in terms of Rule 301 (3) of the Indian Railway Establishment Code, Volume-I. Such notice is not however, required in cases of dismissal or removal as a disciplinary measure after compliance with the provisions of Clause (2) of Article 311 of the Constitution and compulsory retirement due to mental or physical incapacity. (d) A candidate will have to undergo training as prescribed by the Ministry of Railways and pass all the Departmental Examinations. (e) A candidate will be governed by the "Contributory Pension System" effective from 01-01-2004 as per orders of the Government. (f) A candidate will be eligible for leave in accordance with the leave rules as in force from time to time and applicable to officers of his status. (g) A candidate will be eligible for free Railway Passes and Privilege Ticket Orders in accordance with, the rules in force from time to time. (h) A candidate will be required to pass the examination in Hindi of an approved standard within the period of probation and failure to do so shall involve liability to termination of service. (i) Under the rules every person appointed to the above post shall, if so required be liable to serve in any Defence Service or post connected with the Defence of India for a period of not less than four years including the period spent on training, if any: Provided that such person: (a) Shall not be required to serve as aforesaid after the expiry of ten years from the date of such appointment. (b) Shall not ordinarily be required to serve as aforesaid after attaining the age of 45 years. (j) A candidate will be governed in respect of matters specifically referred to above as well as other matter by the provisions of the Indian Railway Establishment Code and the extant orders as amended/issued from time to time. (k) A candidate will undergo Foundation Course training initially and after completion of Foundation Course, the candidate may also be posted to the Railway Health Units/Dispensaries at way side stations, ADMOs are also liable to transfer to any Railway. (1) Prospects of promotion including pay scale and allowances attached to the higher grades will be as per the provisions of Railway Medical Service Recruitment Rules, 2000 and the orders and instructions issued by the Ministry of Railways from time to time. (m) Duties and Responsibilities: Assistant Divisional Medical Officers: (i) He will attend the indoor wards, and out patient department daily and as required. (i) He will carry out physical examination of candidates and of employees in service in accordance with the regulations in force. (ii) He will look after family welfare, public health and sanitation in his jurisdiction. (iv) He will carry out examination of vendors. (v) He will be responsible for discipline and proper discharge of duties of the Hospital Health Unit Staff. (vi) He will carry out duties assigned to him specially if any and will prepare returns and indents connected with his speciality. (vii) He will maintain and ensure upkeep of equipments in his charge. Note 1:- When an ADMOs is posted at the Headquarter of a division under the charge of CMS/Addl.CMS/MS Incharge he will assist the CMS/Addl.CMS/MS Incharge in all his duties but may be specially assigned with certain duties and responsibilities. Note 2:- ADMOs will also be required to perform such other duties as may be assigned to them from time to time. II. Medical Officers Grade in General Duty Medical Officers Sub-cadre of Central Health Service: (a) The posts are temporary but likely to continue indefinitely. Candidates will be appointed to Junior Group `A` scale and they will be on probation for a period of 2 years from the date of appointment which may be curtailed or extended at the discretion of the Competent Authority. They will be confirmed after the satisfactory completion of probation. (b) The candidates can be posted anywhere in India in any dispensary or hospital under any organisation participating in the Central Health Service across India. Private Practice of any kind whatsoever including Lab. and consultant practice is prohibited. (c) The scale of pay admissible to the Medical Officer of CHS is in the Level-10 (Rs. 56,100 to Rs.1,77,500/-) of the pay matrix and NPA as per orders issued by the Government from time to time, and the promotional avenues will be available as per the provision of CHS Rules, 2014 and the orders and instructions issued by the Government from time to time. III. General Duty Medical Officer in the New Delhi Municipal Council: (a) Pay Matrix Level-10 Rs.56,100-1,77,500/- + restricted Non-practicing allowance (NPA). (b) Ordinary rules regarding pensions, gratuity, confirmation etc. as enforced in the Council from time to time will be applicable. (c) The candidate will be on probation for a period of two years from the date of appointment which may be curtailed or extended at the discretion of the competent authority. On satisfactory completion of the probation period will continue in the temporary capacity till confirmed against the permanent vacancy. (d) The candidate can be posted anywhere within the jurisdiction of the N.D.M.C. in any of the hospital/dispensaries/M & C family welfare Centres/Primary Health Centres etc. (e) Private practice of any kind whatsoever is prohibited. (f) The appointment can be terminated on one month's notice on either side during the period of probation and thereafter, while employed in temporary capacity, NDMC reserves the right to one month's pay in lieu of notice. (g) GDMO shall be entitled for promotion as Senior Medical Officer in the Pay Matrix Level-11 Rs.67700- 208700/- and from Senior Medical Officer to Chief Medical Officer in the Pay Matrix Level-12 Rs.78800- 209200/- and from Chief Medical Officer to Chief Medical Officer (Non-functional Selection Grade) in the Pay Matrix Level-13 Rs. 118500-214100/- and Senior Administrative Grade Pay Matrix Level-14 Rs.144200-218200/-. IV. General Duty Medical Officer Gr.II in Municipal Corporation of Delhi: (i) Salary at the minimum of first cell of Rs.56,100/- in the level 10 of 7the Pay Matrix under 7th CPC (corresponding to pre-revised scale in PB-3 Rs.15600-39100+GP Rs.5400/-) plus NPA and other admissible allowances as per rules. (ii) The candidates will be on probation for a period of two year from the date of appointment which may be curtailed or extended at the discretion of the Competent Authority. On satisfactory completion of the probation period, he will continue in the temporary post till confirmed against the permanent vacancy. (iii) The candidate can be posted anywhere within the jurisdiction of the Municipal Corporation of Delhi in anyone of the Hospital/Dispensaries/M&CW and Family Welfare Centres/Primary Health Centres etc. (iv) Private practice of any kind whatsoever is prohibited. (v) The appointment can be terminated on one month's notice on either side during the period of probation and thereafter while employed in temporary capacity. The Municipal Corporation of Delhi reserves the right to pay one month's pay in lieu of notice. Prospects of promotion including pay scale and allowances attached to the higher grades shall be according to the provisions of Recruitment Regulations. APPENDIX-III REGULATIONS RELATING TO THE PHYSICAL/MEDICAL EXAMINATION OF CANDIDATES: A. FOR GENERAL/SC/ST/OBC/EWS CANDIDATES : The regulations are published for the convenience of candidates and to enable them to ascertain the probability of their possessing the required physical standards. The regulations are also intended to provide guidelines to the medical examiners. All posts to be filled on the basis of Combined Medical Services Examination are Group 'A' "Technical” posts. All kinds of notices and information relating to the medical examination of the Transgender candidates including the medical parameters for Transgender candidates for various service(s) would be posted on the dedicated web page of the Ministry of Health & Family Welfare before the commencement of the medical examination of Combined Medical Services Examination 2025 after due consultation with all the concerned nodal authorities and all the Cadre Controlling Authorities of the participating service (s) in Combined Medical Services Examination, 2025. 2. (a) The Government of India reserve to themselves absolute discretion to reject or accept any candidate after considering the report of the Medical Board. (b) To be passed as "fit" for appointment, a candidate must be in good mental and bodily health and free from any physical defect likely to interfere with the efficient performance of the duties of his/her appointment. (c) In the matter of co-relation of age-limit, height, weight and chest girth of candidates of India (including Anglo-Indian race), it is left to the Medical Board to use whatever co-relation of figure is considered most suitable as a guide in the examination of the candidates. Trunk and limbs should be proportionate, no minimum height be insisted upon, if found fit otherwise. If there be any disproportion with regard to height, weight and chest girth, the candidates should be hospitalized for investigation and X-Ray of the chest taken before the candidate is declared fit or unfit by the Board. 3. The candidate's height will be measured as follows:- He/She will remove his/her shoes and be placed against the standard with his/her feet together and the weight thrown on the heels and not on the toe or other sides of the feet. He/She will stand erect without rigidity and with heels, calves, buttocks and shoulders touching the standard, the chin will be depressed to bring the vertex of the head level under the horizontal bar and the height will be recorded in centimeters and parts of a centimeter to halves. 4. The candidate's chest will be measured as follows :- He/She will be made to stand erect with his/her feet together and to raise arms over his/her head. The tape will be so adjusted round the chest that its upper edge touches the inferior angles of the shoulder blades behind and lies in the same horizontal plane when the tape is taken round the chest. The arms will then be lowered to hang loosely by the side and care will be taken that the shoulders are not thrown upwards or backwards so as to displace the tape the candidate will then be directed to take a deep respiration several times and the maximum expansion of the chest will be carefully noted and the minimum and maximum will then be recorded in centimeters 84-89, 86-93.5 etc. in recording the measurement fractions of less than half a centimeter should not be noted. N.B.- The height and chest of the candidates should be measured twice before coming to a final decision. The candidates will also be weighed and his/her weight recorded in kilograms; fractions of half a kilogram should not be noted. 5. (a) The candidate's eye-sight will be tested in accordance with the following rules. The result of each test will be recorded: (i) General- The candidate will be directed to a general examination to the detection of any disease or abnormality of his eyes. The candidate will be rejected if he suffers from any morbid conditions of eye(s), eyelids or contiguous structure of such a short as to render or are likely to render him/her unfit for service on a future date. (ii) Visual Acuity- The examination for determining the acuteness of visions includes two tests- one for distant and the other for near vision. Each eye will be examined separately. (b) There shall be no limit for maximum naked eye vision but the naked eye vision of the candidates shall however be recorded by the Medical Board or other medical authority in every case, as it will furnish the basic information in regard to the condition of the eye. (c) The following standards are prescribed for distant and near vision with or without glasses for different types of services: Class of Service +-----------------------------------+----------------------------+ | Indian Railway Health Service | Service other than IRHS | | (Technical) | (Technical) | +---------------+---------------+---+----------------------------+ | Better eye | Worse eye | | Better eye | Worse eye | +---------------+---------------+---+--------------+-------------+ | 2 | 3 | 4 | 5 | 6 | +---------------+---------------+---+--------------+-------------+ | 1. Distant | 6/6 or 6/9 | 6/9 or 6/12 | 6/6 or 6/9 | 6/12, 6/18 | | Vision | | | | or Nil | +---------------+---------------+---+--------------+-------------+ | 2. Near | J1 | J2 | JI | J2, J3 or | | Vision | | | J2 | Nil | +---------------+---------------+---+--------------+-------------+ | 3. Type of | Spectacles, | IOL/corneal | Spectacles, | IOL | | Correction | IOL/corneal | surgeries | IOL LASIK | LASIK laser | | Permitted | surgeries viz.| viz. (LASIK, | laser | surgery | | | (LASIK, | excimer | surgery | | | | excimer | surgeries etc.)| | | | | surgeries etc.)| may be | | | | | may be | permitted. | | | | | permitted. | Vision should | | | | | Vision should | be stable and | | | | | be stable and | should come up| | | | | should come up| to the | | | | | to the | required | | | | | required | standard. | | | | | standard. | Ophthalmic | | | | | Ophthalmic | Board to clear| | | | | Board to clear| fitness. The | | | | | fitness. The | Surgery should| | | | | Surgery should| have been done| | | | | have been done| at least one | | | | | at least one | year | | | | | year | previously. | | | | | previously. | | | | +---------------+---------------+---+--------------+-------------+ | 4. Limits of | ±4.00D | | Fundus is | | | refractive | In case where | | normal and | | | error | power of lens | | without | | | permitted | is >-4D, a | | pathological | | | | special | | Myopia | | | | ophthalmic | | | | | | Medical Board | | | | | | to clear the | | | | | | case ruling | | | | | | out | | | | | | Pathological | | | | | | Myopia | | | | +---------------+---------------+---+--------------+-------------+ 5. Colour vision Requirements 6. Whether binocular vision needed? Higher grade colour perception (Ishihara test EGL-1.3 mm aperture) Binocular vision is necessary in case of squint. In deserving cases, a special Ophthalmic Medical Board to clear cases on case-to-case basis. Low Grade Colour vision is acceptable. No (d) (i) In respect of the Technical Services mentioned above and any other service concerned with the safety of public the total amount of Myopia(including the cylinder) shall not exceed -4.00 D total amount of Hypermetropia(including the cylinder) shall not exceed +4.00 D: Provided that in case a candidate in respect of the "Technical" services is found unfit on ground of high myopia, the matter shall be referred to a Special Board of three ophthalmologists to declare whether this myopia is pathological or not in case it is not pathological, the candidate shall be declared fit provided he/she fulfils the visual requirements otherwise. (ii) In every case of myopia, fundus examination should be carried out and the results recorded. In the event of pathological condition being present which is likely to be progressive and affect the efficiency of the candidate, he/she should be declared unfit. (e) Field of Vision: The field of vision shall be tested in respect of all services by the confrontation method. When such test gives unsatisfactory or doubtful result the field of vision should be determined on the perimeter. (f) Night Blindness: Broadly there are two types of night blindness: (i) as a result of Vitamin A deficiency and (ii) as a result of Organic disease of Retina-common cause being Retinitis Pigmentosa. In (i) the fundus is normal, generally seen in younger age group and ill-nourished persons and improves by large doses of Vitamin A. In (ii) the fundus is often involved and mere fundus examination will reveal the condition in majority of cases. The Patient in this category is an adult and may not suffer from malnutrition. For both (i) and (ii) dark adaptation test will reveal the condition. The patient in this category is an adult and may not suffer from malnutrition. For both (i) and (ii) dark adaptation test will reveal the condition. (g) Colour Vision: The testing of colour vision shall be essential in respect of the Technical Services mentioned above. Colour perception should be graded into higher and lower grade depending upon the size of aperture in the lantern as described in the table below: - +-------------------------------------+--------------------------+---------------------------+ | Grade | Higher Grade Colour | Lower Grade Colour | | | Perception | Perception | +-------------------------------------+--------------------------+---------------------------+ | 1. Distance between the lamp and the| 16 ft | 16 ft | | candidate. | | | +-------------------------------------+--------------------------+---------------------------+ | 2. Size of aperture | 1.3 mm | 13 mm | +-------------------------------------+--------------------------+---------------------------+ | 3. Time of exposure | 5 seconds | 5 seconds | +-------------------------------------+--------------------------+---------------------------+ For Indian Railway Health Service Higher Grade colour vision is essential but for other services lower grade colour vision will be considered sufficient. Satisfactory colour vision constitutes recognition with ease and without hesitation of Signal red, Signal Green and White Colours. The use of Ishihara's plates, shown in good light and a suitable Edrige Green's Lantern shall be considered quite dependable for testing colour vision. While either of the two tests may ordinarily be considered sufficient in respect of the services other than IRHS, it is essential to carry out the lantern test for IRHS. In doubtful cases where a candidate fails to qualify when tested by only one of the two tests, both the tests should be employed. However, both the Ishihara's plates and Edrige Green's Lantern shall be used for testing colour vision of the candidates for appointment to the Indian Railway Health Service. (h) Ocular condition other than visual acuity : (i) Any organic disease or a progressive refractive error, which is likely to result in lowering visual acuity, should be considered a disqualification. (ii) Squint: For Indian Railway Health Service where the presence of binocular vision is essential, squint, even if the vision acuity in each eye is of the prescribed standard, should be considered a disqualification. For other services, the presence of squint should not be considered as a disqualification, if the visual acuity is of the prescribed standard. (iii) If a person has one eye or if he has one eye which has normal vision and the other eye is amblyopic or has subnormal vision the usual effect is that the person is lacking stereoscopic vision for perception of depth. Such vision is not a disqualification for services other than IRHS. The Medical Board may recommend as fit, such persons:- Provided the normal eye has 6/6 distant vision. J1 near vision with or without glasses provided the error in any meridian is not more than 4 dioptres for distant vision. full field of vision. normal colour vision wherever required: provided the board is satisfied that the candidate can perform all functions for the particular job in question. (iv) Contact Lenses: During the Medical Examination of the candidates, the use of contact lenses is not to be allowed. It is necessary that when conducting eye tests the illumination of the typed lettes for distant vision should have an illumination of 15 foot candles. GUIDELINES FOR SPECIAL OPHTHALMIC BOARD Special Ophthalmic Board for eye examination shall consist of 3 ophthalmologists: (a) Cases where the Medical Board has recorded visual function within normal prescribed limits but suspects a disease of progressive and organic nature which is likely to cause damage to the visual function should refer the candidates to a Special Ophthalmic Board for opinion as part of the first Medical Board. (b) All cases of any type of surgery on eyes, IOL, refractive corneal surgery, doubtful cases of colour defect should be referred to special ophthalmic board. (c) In such cases where a candidate is found to be having high myopia or high hypermetropia the Central Standing Medical Board/State Medical Board should immediately refer the candidates for a Special Board of three Ophthalmologists constituted by the Medical Superintendent of the hospital with the Head of the Department of Ophthalmology of the Hospital or the Seniormost Ophthalmologist as the Chairman of the Special Ophthalmic Board. The Ophthalmologist/Medical Officer who has conducted the preliminary ophthalmic examination cannot be a part of the Special Board. The examination by the Special Board should preferably be done on the same day. Whenever it is not possible to convene the Special Board of three Ophthalmologists on the day of the medical examination by the Central Standing Medical Board/State Medical Board, the Special Board may be convened at an earliest possible date. The Special Ophthalmic Board may carry out detailed investigations before arriving at their decision. The Medical Board's report may not be deemed as complete unless it includes the report of the Special Medical Board for all such cases which are referred to it. GUIDELINE FOR REPORTING ON BORDER LINE UNFIT CASES In border line cases of substandard visual acuity, subnormal colour vision, the test will be repeated after 15 minutes by the Board before declaring a person unfit. 6. Blood Pressure: The Board will use its discretion regarding Blood Pressure. A rough method of calculating normal maximum systolic pressure is as follows : (i) with young subjects of 15-25 years of age, the average is about 100 plus the age. (ii) with subjects over 25 years of age, the general rule of 110 plus half the age seems quite satisfactory. N.B--As a general rule any systolic pressure over 140 mm and diastolic over 90 mm should be regarded as suspicious and the candidate should be hospitalized by the Board before giving their final opinion regarding the candidate's fitness or otherwise. The hospitalization report should indicate whether the rise in blood pressure is of a transient nature due to excitement etc. or whether it is due to any organic disease. In all such cases X-ray and electrocardiographic examination of heart and blood urea clearance test should also be done as routine. The final decision as to fitness or otherwise of a candidate will, however, rest with the medical board only. Method of taking Blood Pressure: - The mercury manometer type of instrument should be used as a rule. The measurement should not be taken within fifteen minutes of any exercise or excitement. Provided the patient and particularly his/her arm is relaxed, he may be either lying or sitting and the arm is supported comfortably at the patient's side in a more or less horizontal position. The arm should be freed from the cloth to the shoulder. The cuff completely deflated should be applied with the middle of the rubber over the inner side of the arm and its lower edge an inch or two above the bend of the elbow. The following returns of cloth bandage should spread evenly over the bag to avoid bulging during inflation. The brachial artery is located by palpitation at the bend of the elbow and the stethoscope is then applied lightly and centrally over it below but not in contact with the cuff. The cuff is inflated to about 200 mm. Hg. and then slowly deflated. The level at which the column stands when soft successive sounds are heard represents the Systolic Pressure. When more air is allowed to escape the sound will be heard to increase in intensity. The level at which the well heard clear sounds change to soft muffed fading sounds represents the diastolic pressure. The measurements should be taken in a fairly brief period of time as prolonged pressure of the cuff is irritating to the patient and will vitiate the reading. Rechecking if necessary should be done only a few minutes after complete deflation of the cuff. Sometimes as the cuff is deflated sounds heard at a certain level may disappear as pressure falls and reappear at a still lower level. This silent gap may cause error in readings. 7. The urine (passed in the presence of the examiner) should be examined and the results recorded. Where a Medical Board finds sugar present in candidate's urine by the usual chemical tests, the Board will proceed with the examination with all its other aspects and will also specially note down any signs or symptoms suggestive of diabetes. If except for the glycosuria the Board finds the candidate conforms to the standard of medical fitness required they may pass the candidates as fit, subject to the glycosuria being non-diabetic and the Board will refer the case to a specified Specialist in Medicine who has hospital and laboratory facilities at his/her disposal. The Medical Specialist will carry out whatever examinations, clinical and/or laboratory, he considers necessary including a standard blood sugar tolerance test, and will submit his/her opinion to the Medical Board upon which the Medical Board will base its final opinion "fit" or "unfit". For this purpose the candidates will not be required to appear in person before the Board on the second occasion. To exclude the effect of medication it may be necessary to retain a candidate for several days in hospital under strict supervision. 8. For appointment against posts which do not prescribe any elaborate training: It shall no longer be necessary to declare a woman candidate as “Temporarily Unfit if she is found to be pregnant during medical examination before appointment against posts which do not prescribe any elaborate training, i.e., she can be appointed straightaway on the job. For production of a medical certificate of fitness from registered medical posts/services that prescribe a training prior to joining working post a women candidate who as a result of test is found to be pregnant should be declared temporary unfit until the confinement is over. She should be re-examined for a fitness certificate six weeks after the date of confinement subject to the practitioner. 9. The following additional points should be observed : - (a) that the candidate's hearing in each ear is good and that there is no sign of disease of the ear. In case it is defective the candidate should be got examined by an ENT Specialist; provided that if the defect in hearing is remediable by operation or by use of a hearing aid a candidate cannot be declared unfit on that account provided he/she has no progressive disease in the ear. This provision is not applicable in the case of IRHS. The following are the guidelines for the medical examination authority in this regard : +-----------------------------------+---------------------------+---------------------------+ | | Indian Railways Health | Services other than IRHS | | | Services (Technical) | (Technical) | +-----------------------------------+---------------------------+---------------------------+ | 1. Marked or total deafness in one| Unfit | Fit, if the deafness is up| | ear other ear being normal. | | to 30 decibel in higher | | | | frequency. | +-----------------------------------+---------------------------+---------------------------+ | 2. Perceptive deafness in both | Fit, if the deafness is up| Fit, if the deafness is up| | ears in which some improvement is | to 30 decibel in speech | to 30 decibel in speech | | possible by a hearing aid. | frequencies of 1000-4000. | frequencies of 1000-4000. | +-----------------------------------+---------------------------+---------------------------+ | 3. Perforation of tympanic | (i) One ear normal, other | (i) One ear normal, other | | membrane of central or marginal | ear having perforation of | ear having perforation of | | type. | tympanic membrane- | tympanic membrane- | | | 'Temporary Unfit'. Under | Temporarily Unfit'. Under | | | improved conditions of | improved conditions of | | | Ear Surgery, a candidate | Ear Surgery, a candidate | | | with marginal or other | with marginal or other | | | perforation in both ears | perforation in both ears | | | should be given a chance | should be given a chance | | | by declaring him | by declaring him | | | temporarily unfit and | temporarily unfit and | | | then he may be considered | then he may be considered | | | under 4(ii) below. | under 4(ii) below. | | | (ii) Marginal or attic | (ii) Marginal or attic | | | perforation in both ears- | perforation in both | | | 'Unfit'. | ears-'Temporarily Unfit'. | | | (iii) Central perforation | | | | in both ears-'Temporarily | | | | Unfit'. | | +-----------------------------------+---------------------------+---------------------------+ | 4. Ears with mastoid cavity | (i) Either ear normal | (i) Either ear normal | | subnormal hearing on one side/on | hearing and other ear | hearing and other ear | | both sides. | with mastoid cavity-'Fit' | with mastoid cavity- | | | (ii) Mastoid cavity of | 'Fit' | | | both sides-'Unfit' | (ii) Mastoid cavity of | | | | both sides-'Unfit' | +-----------------------------------+---------------------------+---------------------------+ | 5. Persistently discharging ear | 'Temporarily Unfit'. | 'Temporarily Unfit'. | | operated/unoperated. | | | +-----------------------------------+---------------------------+---------------------------+ | 6. Chronic inflammatory/allergic | (i) A decision will be | (i) A decision will be | | condition of nose with or | taken as per | taken as per | | with-out bony deformities of nasal| circumstances of | circumstances of | | Septum. | individual cases. | individual cases. | | | (ii) If deviated nasal | (ii) If deviated nasal | | | Septum is present with | Septum is present with | | | Symptoms-Temporarily | Symptoms-Temporarily | | | Unfit' | Unfit' | +-----------------------------------+---------------------------+---------------------------+ | 7. Chronic inflammatory conditions| (i) Chronic inflammatory | (i) Chronic inflammatory | | of tonsils and/or Larynx. | conditions of tonsils | conditions of tonsils | | | and/or Larynx-'Fit'. | and/or Larynx-'Fit'. | | | (ii) Hoarseness of voice | (ii) Hoarseness of voice | | | of severe degree if | of severe degree if | | | present then-'Temporarily | present then- | +-----------------------------------+---------------------------+---------------------------+ +-----------------------------------+---------------------------+---------------------------+ | 8. Benign or locally malignant | Unfit'. | 'Temporarily Unfit'. | | tumours of the E.N.T. | (i) Benign tumours- | (i) Benign tumours- | | | 'Temporarily Unfit'. | 'Temporarily Unfit'. | | | (ii) Malignant Tumour- | (ii) Malignant Tumour- | | | 'Unfit'. | 'Unfit'. | +-----------------------------------+---------------------------+---------------------------+ | 9. Otosclerosis | If the hearing is within | If the hearing is within | | | 30 decibels after | 30 decibels after | | | operation or with the help| operation or with the help| | | of hearing aid-'Fit'. | of hearing aid-'Fit'. | +-----------------------------------+---------------------------+---------------------------+ | 10. Congenital defects of ear, | (i) If not interfering | (i) If not interfering | | nose or throat. | with functions-'Fit'. | with functions-'Fit'. | | | (ii) Stuttering of severe | | | | degree-'Unfit'. | | +-----------------------------------+---------------------------+---------------------------+ | 11. Nasal/Poly | 'Temporarily Unfit'. | 'Temporarily Unfit'. | +-----------------------------------+---------------------------+---------------------------+ (b) that his/her speech is without impediment; (c) that his/her teeth are in good order and that he/she is provided with dentures where necessary for effective mastication (well filled teeth will be considered as sound); (d) that the chest is well formed and his/her chest expansion sufficient and that the hearts and lungs are sound; (e) that there is no evidence of any abdominal disease; (f) that the ear-drum is not ruptured; (g) that he/she does not suffer from hydrocele, varicose veins or piles; (h) that his/her limbs, hands and feet are well formed and developed and that there is free and perfect motion of all joints; (i) that he/she does not suffer from any inveterate skin disease; (j) that there is no congenital malformation or defect; (k) that he/she does not bear traces of acute or chronic disease pointing to an impaired constitution; (1) that he/she bears marks of efficient vaccination; and (m) that he/she is free from communicable disease. 10. Radiographic examination of the Chest should be done as a routine in all cases for detecting any abnormality of the heart and lungs, which may not be apparent by ordinary physical examination in respect of such candidates who are declared finally successful in Combined Medical Services Examination. The decision of the Chairman of the Central Standing Medical Board (conducting the medical examination of the candidate concerned) about the fitness of the candidate shall be final. In case of doubt regarding health of a candidate the Chairman of the Medical Board may consult a suitable Hospital Specialist to decide the issue of fitness or unfitness of the candidate for Government Service, e.g. if a candidate is suspected to be suffering from any mental defect or aberration, the Chairman of the Board may consult a Hospital Psychiatrist/Psychologist, etc. When any defect is found it must be noted in the certificate and the medical examiner should state his/her opinion whether or not it is likely to interfere with the efficient performance of the duties, which will be required of the candidate. In case where a Medical Board considers that a minor disability disqualifying a candidate for Government service can be cured by treatment (medical or surgical) a statement to that effect should be recorded by the Medical Board. There is no objection to a candidate being informed of the Board's opinion to this effect by appointing authority and when a cure has been effected it will be open to the authority concerned to ask for another Medical Board. In the case of candidates who are to be declared “Temporarily Unfit” the period specified for re-examination should not ordinarily exceed six months at the maximum. On re-examination after the specified period these candidates should not be declared temporarily unfit for a further period but a final decision in regard to their fitness for appointment or otherwise should be given. It may be noted that a Candidate when suffering from a curable disease can be declared temporarily unfit by the first Medical Board only. The Medical re-examination shall be deemed to be part of the 1st Medical Examination and candidates may, if they desire, appeal against its decision. The appellate Medical Board has to come to a final decision and state clearly whether a candidate is fit or unfit, a candidate cannot be declared temporarily unfit on the basis of the appellate medical examination. 10. The candidates filing an appeal against the decision of the Medical Board have to deposit an appeal fee of Rs.100.00 in such manner as may be prescribed by the Government of India in this behalf. Appeals should be submitted within 21 days of the date of the communication in which the decision of the Medical Board is communicated to the candidates; otherwise request for second Medical Examination by an Appellate Medical Board will not be entertained. The Medical Examination by the Appellate Medical Board would be arranged in New Delhi only and no travelling allowance or daily allowance will be admissible for the journeys performed in connection with the Medical Examination. The decision of the Appellate Medical Board will be final and no appeal shall be against the same. B. FOR CANDIDATES OF CATEGORY OF PERSONS WITH BENCHMARK DISABILITY AS PER RPwD Act 2016: The regulations are published for the convenience of candidates and to enable them to ascertain the probability of their possessing the required physical standards. The regulations are also intended to provide guidelines to the medical examiners. All posts to be filled on the basis of Combined Medical Services Examination are Group 'A' “Technical" posts. 2. (a) The Government of India reserve to themselves absolute discretion to reject or accept any candidate after considering the report of the Medical Board. (b) To be passed as "fit" for appointment, a candidate must be in good mental and bodily health and free from any physical defect likely to interfere with the efficient performance of the duties of his/her appointment. (c) In the matter of co-relation of age-limit, height, weight and chest girth of candidates of India (including Anglo-Indian race), it is left to the Medical Board to use whatever co-relation of figure is considered most suitable as a guide in the examination of the candidates. Trunk and limbs should be proportionate, no minimum height be insisted upon, if found fit otherwise. If there be any disproportion with regard to height, weight and chest girth, the candidates should be hospitalized for investigation and X-Ray of the chest taken before the candidate is declared fit or unfit by the Board. 3. The candidate's height will be measured as follows:- He/She will remove his/her shoes and be placed against the standard with his/her feet together and the weight thrown on the heels and not on the toe or other sides of the feet. He/She will stand erect without rigidity and with heels, calves, buttocks and shoulders touching the standard, the chin will be depressed to bring the vertex of the head level under the horizontal bar and the height will be recorded in centimeters and parts of a centimeter to halves. 4. The candidate's chest will be measured as follows :- He/She will be made to stand erect with his/her feet together and to raise arms over his/her head. The tape will be so adjusted round the chest that its upper edge touches the inferior angles of the shoulder blades behind and lies in the same horizontal plane when the tape is taken round the chest. The arms will then be lowered to hang loosely by the side and care will be taken that the shoulders are not thrown upwards or backwards so as to displace the tape the candidate will then be directed to take a deep respiration several times and the maximum expansion of the chest will be carefully noted and the minimum and maximum will then be recorded in centimeters 84-89, 86-93.5 etc. in recording the measurement fractions of less than half a centimeter should not be noted. N.B.- The height and chest of the candidates should be measured twice before coming to a final decision. The candidates will also be weighed and his/her weight recorded in kilograms; fractions of half a kilogram should not be noted. 1. Locomotor Disability : Candidates with 40-80% disability are eligible for PwBD quota. Persons with more than 80% disability are allowed on case to case basis, if and only if, there is an improvement in the functional competence with the aid of assistive devices. Or in other words, disability is brought down below 80% as required to perform the necessary functions to be certified so by a designated Special Board. In case of leprosy cured persons, attention should be paid to loss of sensations in fingers and hands, amputation, as well as involvement of eyes and corresponding recommendations is looked at. In case of Cerebral palsy, attention should be paid to impairment of vision, hearing, cognitive function etc and corresponding recommendations be looked at. CHS: Appendix IV shall be referred for category (ies) of Persons with Benchmark Disability which are identified suitable for General Duty Medical Officer of CHS along with their Functional classification and Physical requirements. For IRHS: Existing Locomotor disability for PwBD only with functional classification of OA, OL and BL in direct recruitment of ADMOs in IRHS through CMSE. Visual Disability : Candidates with visual acuity disability in range of more than 40% disability are eligible, subject to the condition that the visual disability is brought down to a level of less than the benchmark of 40% with the advanced low vision aids and appliances. This is to be certified so by a designated Special Board. CHS: Appendix IV shall be referred for category (ies) of Persons with Benchmark Disability which are identified suitable for General Duty Medical Officer of CHS along with their Functional classification and Physical requirements. Visual Acuity: IRHS: Candidates with 'Sub Standard' Visual Acuity are not suitable to man posts of ADMOs in IRHS. Colour Vision : IRHS: Candidates with Colour Vision defects are not suitable to man posts of ADMOs in IRHS. 2. Hearing Disability: Candidates with more than 40% disability to be considered eligible, subject to the condition that the hearing disability is brought down to a level of less than the benchmark of 40% with the aid of assistive devices as certified so by a designated Special Board. In addition to this, individual should have a speech discrimination score of more than 60%. CHS: Appendix IV shall be referred for category (ies) of Persons with Benchmark Disability which are identified suitable for General Duty Medical Officer of CHS along with their Functional classification and Physical requirements. IRHS: Candidates with Hearing disability are not suitable to man posts of ADMOs in IRHS. 3. Other Disabilities (Autism, Intellectual disabilities, Specific Learning Disabilities and Mental Illness) : INTELLECTUAL DISABILITY: i. Autism – Currently not recommended due to lack of objective method to establish presence and extent of mental illness. ii. Specific Learning disability: Equal to or more than 40% disability and equal to or less than 80% will be eligible. But selection will be based on the learning competency evaluated with the help of the remediation/assisted technology/aids/infrastructural changes by the Expert Panel. [Currently, there is no quantification scale available to assess the severity of Specific Learning Disability. Therefore, the cut off of 40% is arbitrary and more evidence is needed. MENTAL ILLNESS: Currently not recommended due to lack of objective method to establish present and extent of mental illness. However, the benefit of reservation/quota may be considered in future after developing better methods of disability assessments. CHS: Appendix IV shall be referred for category (ies) of Persons with Benchmark Disability which are identified suitable for General Duty Medical Officer of CHS along with their Functional classification and Physical requirements. Autism and Intellectual Disability : IRHS: Candidates with Autism and Intellectual Disabilities are not suitable to man posts of ADMOs in IRHS. GUIDELINES FOR SPECIAL OPHTHALMIC BOARD Special Ophthalmic Board for eye examination shall consist of 3 ophthalmologists: a) Cases where the Medical Board has recorded visual function within normal prescribed limits but suspects a disease of progressive and organic nature which is likely to cause damage to the visual function should refer the candidates to a Special Ophthalmic Board for opinion as part of the first Medical Board. b) All cases of any type of surgery on eyes, IOL, refractive corneal surgery, doubtful cases of colour defect should be referred to special ophthalmic board. c) In such cases where a candidate is found to be having high myopia or high hypermetropia the Central Standing Medical Board/State Medical Board should immediately refer the candidates for a Special Board of three Ophthalmologists constituted by the Medical Superintendent of the hospital with the Head of the Department of Ophthalmology of the Hospital or the Seniormost Ophthalmologist as the Chairman of the Special Ophthalmic Board. The Ophthalmologist/Medical Officer who has conducted the preliminary ophthalmic examination cannot be a part of the Special Board. The examination by the Special Board should preferably be done on the same day. Whenever it is not possible to convene the Special Board of three Ophthalmologists on the day of the medical examination by the Central Standing Medical Board/State Medical Board, the Special Board may be convened at an earliest possible date. The Special Ophthalmic Board may carry out detailed investigations before arriving at their decision. The Medical Board's report may not be deemed as complete unless it includes the report of the Special Medical Board for all such cases which are referred to it. GUIDELINE FOR REPORTING ON BORDER LINE UNFIT CASES In border line cases of substandard visual acuity, subnormal colour vision, the test will be repeated after 15 minutes by the Board before declaring a person unfit. 6. Blood Pressure: The Board will use its discretion regarding Blood Pressure. A rough method of calculating normal maximum systolic pressure is as follows : a) with young subjects of 15-25 years of age, the average is about 100 plus the age. b) with subjects over 25 years of age, the general rule of 110 plus half the age seems quite satisfactory. N.B--As a general rule any systolic pressure over 140 mm and diastolic over 90 mm should be regarded as suspicious and the candidate should be hospitalized by the Board before giving their final opinion regarding the candidate's fitness or otherwise. The hospitalization report should indicate whether the rise in blood pressure is of a transient nature due to excitement etc. or whether it is due to any organic disease. In all such cases X-ray and electrocardiographic examination of heart and blood urea clearance test should also be done as routine. The final decision as to fitness or otherwise of a candidate will, however, rest with the medical board only. Method of taking Blood Pressure: - The mercury manometer type of instrument should be used as a rule. The measurement should not be taken within fifteen minutes of any exercise or excitement. Provided the patient and particularly his/her arm is relaxed, he may be either lying or sitting and the arm is supported comfortably at the patient's side in a more or less horizontal position. The arm should be freed from the cloth to the shoulder. The cuff completely deflated should be applied with the middle of the rubber over the inner side of the arm and its lower edge an inch or two above the bend of the elbow. The following returns of cloth bandage should spread evenly over the bag to avoid bulging during inflation. The brachial artery is located by palpitation at the bend of the elbow and the stethoscope is then applied lightly and centrally over it below but not in contact with the cuff. The cuff is inflated to about 200 mm. Hg. and then slowly deflated. The level at which the column stands when soft successive sounds are heard represents the Systolic Pressure. When more air is allowed to escape the sound will be heard to increase in intensity. The level at which the well heard clear sounds change to soft muffed fading sounds represents the diastolic pressure. The measurements should be taken in a fairly brief period of time as prolonged pressure of the cuff is irritating to the patient and will vitiate the reading. Rechecking if necessary should be done only a few minutes after complete deflation of the cuff. Sometimes as the cuff is deflated sounds heard at a certain level may disappear as pressure falls and reappear at a still lower level. This silent gap may cause error in readings. 5. The urine (passed in the presence of the examiner) should be examined and the results recorded. Where a Medical Board finds sugar present in candidate's urine by the usual chemical tests, the Board will proceed with the examination with all its other aspects and will also specially note down any signs or symptoms suggestive of diabetes. If except for the glycosuria the Board finds the candidate conforms to the standard of medical fitness required they may pass the candidates as fit, subject to the glycosuria being non-diabetic and the Board will refer the case to a specified Specialist in Medicine who has hospital and laboratory facilities at his/her disposal. The Medical Specialist will carry out whatever examinations, clinical and/or laboratory, he considers necessary including a standard blood sugar tolerance test, and will submit his/her opinion to the Medical Board upon which the Medical Board will base its final opinion "fit" or "unfit". For this purpose the candidates will not be required to appear in person before the Board on the second occasion. To exclude the effect of medication it may be necessary to retain a candidate for several days in hospital under strict supervision. 6. For appointment against posts which do not prescribe any elaborate training : It shall no longer be necessary to declare a woman candidate as "Temporarily Unfit if she is found to be pregnant during medical examination before appointment against posts which do not prescribe any elaborate training, i.e., she can be appointed straightaway on the job. For production of a medical certificate of fitness from registered medical posts/services that prescribe a training prior to joining working post a women candidate who as a result of test is found to be pregnant should be declared temporary unfit until the confinement is over. She should be re-examined for a fitness certificate six weeks after the date of confinement subject to the practitioner. 7. Radiographic examination of the Chest should be done as a routine in all cases for detecting any abnormality of the heart and lungs, which may not be apparent by ordinary physical examination in respect of such candidates who are declared finally successful in Combined Medical Services Examination. The decision of the Chairman of the Central Standing Medical Board (conducting the medical examination of the candidate concerned) about the fitness of the candidate shall be final. 8. In case of doubt regarding health of a candidate the Chairman of the Medical Board may consult a suitable Hospital Specialist to decide the issue of fitness or unfitness of the candidate for Government Service, e.g. if a candidate is suspected to be suffering from any mental defect or aberration, the Chairman of the Board may consult a Hospital Psychiatrist/Psychologist, etc. 9. When any defect is found it must be noted in the certificate and the medical examiner should state his/her opinion whether or not it is likely to interfere with the efficient performance of the duties, which will be required of the candidate. In case where a Medical Board considers that a minor disability disqualifying a candidate for Government service can be cured by treatment (medical or surgical) a statement to that effect should be recorded by the Medical Board. There is no objection to a candidate being informed of the Board's opinion to this effect by appointing authority and when a cure has been effected it will be open to the authority concerned to ask for another Medical Board. In the case of candidates who are to be declared “Temporarily Unfit” the period specified for re-examination should not ordinarily exceed six months at the maximum. On re-examination after the specified period these candidates should not be declared temporarily unfit for a further period but a final decision in regard to their fitness for appointment or otherwise should be given. It may be noted that a Candidate when suffering from a curable disease can be declared temporarily unfit by the first Medical Board only. The Medical re-examination shall be deemed to be part of the 1st Medical Examination and candidates may, if they desire, appeal against its decision. The appellate Medical Board has to come to a final decision and state clearly whether a candidate is fit or unfit, a candidate cannot be declared temporarily unfit on the basis of the appellate medical examination. 10. The candidates filing an appeal against the decision of the Medical Board have to deposit an appeal fee of Rs.100.00 in such manner as may be prescribed by the Government of India in this behalf. Appeals should be submitted within 21 days of the date of the communication in which the decision of the Medical Board is communicated to the candidates; otherwise request for second Medical Examination by an Appellate Medical Board will not be entertained. The Medical Examination by the Appellate Medical Board would be arranged in New Delhi only and no travelling allowance or daily allowance will be admissible for the journeys performed in connection with the Medical Examination. The decision of the Appellate Medical Board will be final and no appeal shall be against the same. Shri NIKHIL GAJRAJ, Jt. Secy. APPENDIX-IV A list of Services Identified suitable for Persons with Benchmark Disability along with the Functional Classifications and Physical Requirements +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ | Sl. | Name of the | Category(ies) for which | Functional | Physical | | No. | Service | Identified | Classification | Requirements | +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ | (1) | (2) | (3) | (4) | (5) | +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ | 1. | Assistant | Locomotor Disability | (i) OA-One arm affected. | S, ST, BN, W, SE, | | | Divisional | | (ii) OL-One leg affected | MF, C, RW, H | | | Medical Officer | | and | S-Sitting, | | | (ADMO) in | | (iii) BL-Both legs | ST-Standing, BN- | | | Indian Railway | | affected but not arms. | Bending, W- | | | Health Services | | (iv) LC-Leprosy cured | Walking, SE-Seeing,| | | (IRHS) | | (v) AAV-Acid Attack | MF-Manipulation | | | | | Victim without joint | by Fingers, C- | | | | | involvement | Comm-unication, | | | | | | RW- Reading and | | | | | | Writing, H- Hearing| +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ | 2. | Medical Officers | (a) OA, OL, BL, LC, DW, | S, ST, W, BN, MF, RW, | S=Sitting, | | | Grade in Central | AAV | SE, H, C | ST=Standing, | | | Duty Medical | (b) SLD | S=Sitting, ST=Standing, | W=Walking, BN= | | | Officers Sub- | (c) MD involving (a) to (b)| W=Walking, BN=Bending, | Bending, | | | cadre of Central | above | MF=Manipulation with | MF=Manipulation | | | Health Service. | | Fingers, RW=Reading & | with Fingers, | | | | | Writing, SE=Seeing, H= | RW=Reading & | | | | | Hearing, C=Communication | Writing, SE=Seeing,| | | | | Incumbent should be | H=Hearing, C= | | | | | considered with aids & | Communication | | | | | appliances, Bilateral | | | | | | hand activities should be| | | | | | adequate. | | +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ | 3. | General Duty | a) OA, OL, BL, LC, DW, | NIL | S, ST, W, BN, MF, | | | Medical Officer | AAV | | RW, SE, H, C | | | Gr.II in MCD | b) SLD | | | | | | c) MD involving (a) to (b)| | | | | | above | | | +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ | 4. | General Duty | Locomotor Disability | OA & OL only | S, ST, BN, W, SE, | | | Medical Officer | | (Functional | MF, C, RW, H | | | in NDMC | | Classification-OH (OA, | S-Sitting, | | | | | OL) with leprosy cured, | ST-Standing, BN- | | | | | dwarfism, acid attack | Bending, W- | | | | | victims) | Walking, SE-Seeing,| | | | | | MF-Manipulation | | | | | | by Fingers, C- | | | | | | Comm-unication, | | | | | | RW- Reading and | | | | | | Writing, H- Hearing| +-----+-----------------------------------+----------------------------+--------------------------+--------------------+ APPENDIX – V Certificate regarding physical limitation in an examinee to write This is to certify that, I have examined Mr./Ms./Mrs. ............................................. (name of the candidate with benchmark disability), a person with .................................................... (nature and percentage of disability as mentioned in the certificate of disability), S/o /D/o........................................ a resident of ................................................................... (Village/District/State) and to state that he/she has physical limitation which hampers his/her writing capabilities owing to his/her disability. ................................................................................................................. Signature ................................................................ Chief Medical Officer/Civil Surgeon / Medical Superintendent of a Government Health Care Institution. Note: Certificate should be given by a specialist of the relevant stream/disability (eg. Visual Impairment – Ophthalmologist, Locomotor disability – Orthopaedic specialist/PMR). APPENDIX – VI Letter of Undertaking for Using Own Scribe (To be filled by the candidates online to the Commission) I............................................., a candidate with.......................................(name of the disability) appearing for the .....................................(name of the examination)...................................bearing Roll No.............................at ..........................(name of the centre) in the District .................................................(name of the State). My qualification is ........................... I do hereby state that ...........................................(name of the scribe) will provide the service of scribe/reader/lab assistant for the undersigned for taking the aforesaid examination. I do hereby undertake that his qualification is ................................. In case, subsequently it is found that his/her qualification is not as declared by the undersigned and is beyond my qualification, I shall forfeit my right to the post and claims thereto. (Signature of the candidates with Disability) Place: Date: APPENDIX-VII Certificate for person with specified disability covered under the definition of Section 2(s) of the RPwD Act, 2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having less than 40% disability and having difficulty in writing This is to certify that, we have examined Mr./Ms./Mrs.......................................................................................... (name of the candidate), S/o / D/o .................................................................................... a resident of ..................................................................... (Vill/PO/PS/District/State), aged...............yrs, a person with ..................................................................... (nature of disability/condition), and to state that he/she has limitation which hampers his/her writing capability owing to his/her above condition. He/she requires support of scribe for writing the examination. 2. The above candidate uses aids and assistive device such as prosthetics & orthotics, hearing aid (name to be specified) which is /are essential for the candidate to appear at the examination, with the assistance of scribe. 3. This certificate is issued only for the purpose of appearing in written examinations conducted by recruitment agencies as well as academic institutions and is valid upto ....................................(it is valid for maximum period of six months or less as may be certified by the medical authority) ............................................................................................................. Signature of medical authority +---------------------------+---------------------------+---------------------------+---------------------------+---------------------------+ | (Signature & Name) | (Signature & Name) | (Signature & Name) | (Signature & Name) | (Signature & Name) | +---------------------------+---------------------------+---------------------------+---------------------------+---------------------------+ | Orthopedic/ PMR | Clinical phychologist/ | Neurologist | Occupational | Other Expert, as | | Specialist | Rehabilitation | (if available) | therapist | nominated by the | | | Psychologist/ | | (if available) | Chairperson | | | Psychiatrist/Special | | | (if any) | | | Educator | | | | +---------------------------+---------------------------+---------------------------+---------------------------+---------------------------+ .........................................................................(Signature & Name) Chief Medical Officer / Civil Surgeon / Chief District Medical Officer ....................................................... Chairperson Place : Date : Name of Government Hospital / Health Care Centre with seal APPENDIX – VIII MEDICAL BOARD REPORT FORMAT (To be filled in Triplicate) For CMSE-2025 Photograph with Roll No. & Discp. written on the back Name of Hospital....................................................................................................... Place ............................................ (a) Candidate's statement and declaration. Candidate must make the statement required below in his/her own hand writing prior to his Medical Examination and must sign the declaration 'appended thereto'. Their attention is specially directed to the warning contained in the Para 08 below:- 1. Name in full(in block letters) : ....................................................... 3(c). Whether underwent any eye surgery (including Radial Keratotomy / Lasik/Excimer etc.) at any time. If yes, details thereof: ..................................................................... ....................................................................................................... 2(a). Age : ........... Date of Birth: ............ Place of Birth: ................... 3(d) (i) whether PwBD candidate - Yes/No ....................................................................................................... (ii) Mention Sub-category of Disability 2(b). Do you belong to races such as Gorkhas, Garhwalis, .............. (ex. OL, OA, BL, etc.) Assamese, Nagaland Tribals etc, whose average height is ....................................................................................... distinctly lower? Answer 'Yes' or 'No' and if the answer is ....................................................................................... 'Yes' state the name of the tribe race : ...................................... 4. Have you suffered from any form of nervousness due to ....................................................................................................... overwork or any other causes ............................... 3(a). Have you ever had small-pox intermittent or any fever, enlargement or suppuration of glands, spitting of Blood, asthma, heart diseases, lung disease, fainting attacks, rheumatism, appendicitis : ......................................... ....................................................................................................... ....................................................................................................... ....................................................................................................... Or 3(b). Any other disease or accident requiring confinement to bed and medical or surgical treatment : ............................ ....................................................................................................... ....................................................................................................... ....................................................................................................... ....................................................................................................... 5. Have you been allotted to any service/posts on the basis of previous years exams? If yes, give details thereof ........... ....................................................................................................... Have you joined the said service/post ................................ ....................................................................................................... 5.1 Are you enrolled for the PG course? If yes, give details thereof ................................................................................... ....................................................................................................... 6. Furnish the following particulars concerning your family:- +---------------+---------------+---------------------------+---------------------------+---------------------------+---------------------------+ | Father's age, | Father's age | No. of | No. of | Mother's age | Mother's age | No. of sisters | No. of sisters | | if living & | at death & | brothers | brothers dead,, | if living & | at death & | living, their | dead, their | | state of | cause of | living, their | their ages & | state of | cause of | ages & state | ages & cause | | health | death | ages & state | cause of death | health | death | of health | of death | | | | of health | | | | | | +---------------+---------------+---------------------------+---------------------------+--------------+--------------+---------------------------+---------------------------+ | (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | +---------------+---------------+---------------------------+---------------------------+--------------+--------------+---------------------------+---------------------------+ | | | | | | | | | +---------------+---------------+---------------------------+---------------------------+--------------+--------------+---------------------------+---------------------------+ | | | | | | | | | +---------------+---------------+---------------------------+---------------------------+--------------+--------------+---------------------------+---------------------------+ | | | | | | | | | +---------------+---------------+---------------------------+---------------------------+--------------+--------------+---------------------------+---------------------------+ Present Address........................................................................................................................................................ Mobile No..................................................................... Email ID .................................................................... Mobile No. of Father/Guardian .......................................................................................................................... Identification marks.............................................................................................................................................. 7. Details of medical examination conducted before, if any:- (a) Place & Date of Medical Board ........................................................................................................... (b) Service(s)/Post(s) for which examined year of Examination .......................................................... and .......................................................... (c) Result of Medical Board Examination if communicated or known. .................................................................................................................................................. 8. All the above answers are to the best of my knowledge & belief, true and correct and I shall be liable for action under law for any material infirmity in the information furnished by me or suppression of relevant material information. The furnishing of false information or suppression of any factual information would be a disqualification and is likely to render me unfit for employment under the Government. I am fully aware of the provisions of Combined Medical Services Examination-2025 Rules. If the fact that false information has been furnished or that there has been suppression of any factual information comes to notice at any time during my service, my services would be liable to be terminated. Candidate's Signature ............................................ Signed in my presence ............................................ Signature of the Chairperson of the Board with date and stamp of the Board (b) Report of the Medical Board on (name of candidate) ............................................................................. ................................................................................................................................................................................. (Examiner to write and not merely Tick the correct choice) Physical examination 1. General development: (Good/Fair/Poor) ............................................ Nutrition (Thin/Average/Obese) .......................................................... 3. Eyes i. Any disease ............................................ ii. Night Blindness ............................................ Height (without shoes) .............................Cms. Weight ....................................................kg Temperature ...........................................°C iii. Colour vision (Higher Grade/Lower Grade) .............................. ....................................................................................................... iv. Field of vision ............................................................................. Method......................................................................................... Girth of chest :- (i) (After full inspiration) ......................Cms (ii) (After full expiration) .........................Cms v. Binocular vision .......................................................................... ....................................................................................................... 2. Skin - Any obvious disease ............................................ ....................................................................................................... ....................................................................................................... vi. Fundus Examination ................................................................... ....................................................................................................... ....................................................................................................... ....................................................................................................... vii. Visual Acuity +---------------+------------+---------------+---------------------------+ | Acuity of | Naked eye | With glasses | Strength of glasses | | vision | | | | +---------------+------------+---------------+-------------+-------------+ | | | | Spherical | Cylindrical | +---------------+------------+---------------+-------------+-------------+ | Distant | R.E. | | | | | Vision | | | | | | | L.E. | | | | +---------------+------------+---------------+-------------+-------------+ | Near Vision | R.E. | | | | | | | | | | | | L.E. | | | | +---------------+------------+---------------+-------------+-------------+ | Hypermetropia | R.E. | | | | | (Manifest) | | | | | | | L.E. | | | | +---------------+------------+---------------+-------------+-------------+ | | | | | Axis | +---------------+------------+---------------+-------------+-------------+ | | | | | | +---------------+------------+---------------+-------------+-------------+ | | | | | | +---------------+------------+---------------+-------------+-------------+ | | | | | | +---------------+------------+---------------+-------------+-------------+ 4. Ears: Inspection ............................................ Hearing ........................................................... Right Ear ........................................................ Left Ear ........................................................... 9.(b) Haemorhoids ............................................ Fistula .............................................................. 10. Nervous System: Indications of nervous or mental disabilities ............................................................. .......................................................................... .......................................................................... (a) Motor ......................................................... (b) Sensory......................................................... 11. Loco-Motor System: Any abnormality ................ .......................................................................... .......................................................................... .......................................................................... .......................................................................... 5. Glands .......................................................... Thyroid ............................................................. 6. Condition of teeth & gums .............................. .......................................................................... .......................................................................... .......................................................................... 7. Respiratory System: Does physical examination reveal anything abnormal in the respiratory organs? .......................................................................... .......................................................................... .......................................................................... 12(A) Genito Urinary System: Any evidence of Hydrocele, Varicocele etc. .................................. .......................................................................... .......................................................................... .......................................................................... 8. Circulatory system: (a) Heart: Any organic lesions? ............................ Rate/Minutes Standing ..................../Minutes After hopping 25 times ......../Minutes Two minutes after hopping ......../Minutes (b) Blood Pressure: Systolic .....................mm of Hg Diastolic ...................mm of Hg 9. Abdomen: Girth ...........................Cms (explain if any finding).......................................... .......................................................................... .......................................................................... Hernia ............................................................. (a) Palpable: ..................................................... Liver ........................................................... Spleen ......................................................... Kidneys ........................................................ Any Mass ..................................................... (explain)........................................................ .......................................................................... .......................................................................... Urine analysis (Lab. No. .....................................) (a) Physical Appearance .................................... .......................................................................... (b) Sp. Gravity .................................................. (c) Albumin ...................................................... (d) Sugar ......................................................... (e) Casts........................................................... (f) Cells............................................................ 12(B) *Gyane Examination (for female candidates only)................................................................... .......................................................................... .......................................................................... .......................................................................... .......................................................................... Sign. of Doctor ............................................ 13. Report of X-ray examination of chest (X-ray No....................) ................................................ .......................................................................... 14. Is there anything in the health of the candidate likely to render him unfit for the efficient discharge of his duties in the service for which he is a candidate? ............................................................................................................ ................................................................................................................................................................................. NOTE: *In the case of a female candidate, if it is found that she is pregnant, she should be declared temporarily unfit, vide Regulation as per notification. 15. Services for which the candidate has been found qualified for the efficient and continuous discharge of duties may please be indicated clearly by √ and services/posts for which he /she is considered unfit if any may also please be indicated clearly by × :- i) Indian Railway Health Service (ADMO) ii) Central Health Service (Medical Officers Grade in General Duty Medical Officers) iii) New Delhi Municipal Council (GDMO) iv) Municipal Corporation of Delhi (GDMO Gr.II) Is the candidate fit for field service? .................................................................................................................... NOTE: The Board should record their findings strictly in the following certificate CERTIFICATE Shri ................................................................................................. Roll No. ........................................ a candidate of CMSE-2025 who has appeared for his first medical examination/ re-examination on .................................... (date) is found to be (i) Fit ...................................................................................................... (ii) Unfit on account of ............................................................................ (iii) Temporarily unfit on account of .......................................................... (pl ensure this matches with findings of Column 14 at page 3 (iv) In case of PwBD please mention the category/sub-category of disability i.e OA, OL, BL, etc. (please refer Appendix-IV of CMSE Rules and ensure PwBD candidates meet with Functional Classification and Physical Requirements for identified services) Sign. of Member with stamp (containing name) If co-opted Sign. of Member with stamp (containing name) Sign. of Chairperson with stamp (containing name) Sign. of Member with stamp (containing name) Date: PLACE: ANNEXURE I I. Technical Services or posts requiring Higher Grade Colour Perception:- i) Indian Railway Health Service (ADMO) II. Technical Services or posts requiring Lower Grade Colour Perception:- (or Defective Higher Grade Colour Perception – DHGCP) i) Central Health Service (Medical Officers Grade in General Duty Medical Officers) ii) New Delhi Municipal Council (GDMO) ii) Municipal Corporation of Delhi (GDMO Gr.II) Sign. of Member with stamp (containing name) If co-opted Sign. of Member with stamp (containing name) Sign. of Chairperson with stamp (containing name) Sign. of Member with stamp (containing name) APPENDIX-IX Letter of Undertaking by the person with specified disability covered under the definition of Section 2(s) of the RPwD Act, 2016 but not covered under the definition of Section 2(r) of the said Act, i.e. persons having less than 40% disability and having difficulty in writing I................................................................. a candidate with........................................(nature of disability/condition) appearing for the .....................................(name of the examination)...................................bearing Roll No.............................at ..........................(name of the centre) in the District .................................................(name of the state). My educational qualification is ........................... 2. I do hereby state that ...........................................(name of the scribe) will provide the service of scribe for the undersigned for taking the aforementioned examination. 3. I do hereby undertake that his qualification is ................................. In case, subsequently it is found that his qualification is not as declared by the undersigned and is beynd my qualification. I shall forefeit my right to the post or certificate/diploma/degree and claims relating thereto. (Signature of the candidate) Place : Date: APPENDIX-X UNDERTAKING FOR REGISTRATION OF NEW MOBILE NUMBER AND EMAIL ID IN THE OTR PROFILE TO WHOMSOEVER IT MAY CONCERN I, ..................................................................... son/daughter of ................................................... undertake that I have applied for the ...................................................Exam, ...........YYYY, with the following details and that I have lost access to my registered mobile number as well as to my registered email ID. I have attached the necessary supporting documents as proof of my claim. I declare that the information provided by me is true, and in case of any discrepancy found later, I will be fully responsible. I understand that this correction is subject to verification and approval by the authorities. My details are as under: Name : Father's Name : Date of Birth : Registered Mobile No.: Registered Email ID: New Mobile No. to be registered: New Email ID to be registered: Yours sincerely, [Signature] Name............................................ List of documents attached: (a) Matriculation Certificate (b) Aadhar Card or PAN Card or Passport or Driving License (c) Recent passport size photograph *** Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064 and Published by the Controller of Publications, Delhi-110054. GORAKHA NATH YADAVA Digitally signed by GORAKHA NATH YADAVA Date: 2025.02.24 14:12:57 +05'30'