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CONCESSION
CERTIFICATE |
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Paste Passport size photograph duly signed and stamped by the issuing Doctor |
Form for the purpose of grant of rail
concession to Totally Deaf & Dumb persons (both
afflictions together in the same person) to be used by the
Government Doctor. |
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This is to certify that Km./ Shri / Smt._____________________________________________ whose particulars are, furnished below, is a TOTALLY DEAF & DUMB PERSON. |
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Particulars of the totally deaf & dumb person: |
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(a) Address:_________________________________________________________________ |
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(b) Father's /Husband's Name: ___________________________________________________ |
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(c) Age:______________________ |
(d) Sex ___________________ |
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(e) Signature or left hand Thumb |
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Place :_____________ |
__________________________________________ |
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Date :_____________ |
(Signature of Government Doctor) |
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__________________________ |
__________________________________________ |
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Clear Seal of Government |
Seal Containing full name and Regn. No. of Doctor |
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Note : 1). The Certificate should be issued only to Totally Deaf & Dumb persons (both afflictions together in the same person). The photo must be signed and stamped by the certificate issuing Doctor in such a way that the signature and stamp appears partly on the photo and partly on the certificate. |
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| 2). The certificate is valid for five years from the date of issue. After expiry of the period of validity of the certificate, the person is required to obtain a fresh certificate. A Photostat copy of the certificate is accepted for the purpose of grant of concession. The original certificate will have to be produced for inspection at the time of purchase of concessional ticket and during the journey, if demanded. |
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3). No alteration in the form is
permitted. |
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