Latest Sabarimala Medical Certificate Format Download

Download Sabarimala Medical Certificate Format

Find the medical certificate format which needs to shown while you trek to Sabarimala this year (2022) mandala celebration.  The Sabarimala medical certificate needs to be signed by the Medical Officer along with their registration number. 


COVID 19 results should be performed within 48 Hours prior to obtaining of consultation. The certificate is valid for 48hrs from the date of issue.


CERTIFICATE OF COVID STATUS and MEDICAL FITNESS FOR SABARIMALA PILGRIMAGE

 

        I Dr ………………………       …………………….(Designation with institution name ) have examined Mr/Ms/Mrs………………………………………………………… Age (years ………….……………..address with Govt issued Identify card ( Aadhar Card, Election Card, PAN Card, Driver’s License) ………………………….……………………………………………………… on date dd/mm/yyyy and found that he/she is COVID Negative as per the test (Antigen/RTPCR/TRUENAT/CBNAT/XPERT) performed on ………………..(date).

( Copy of the test should be attached)


He/ she is not having signs/symptoms (Fever, Rhinitis, cough, sore throat, Breathing difficulty, diarrhea , loss smell/taste, excessive fatigue) of COVID 19 at the time of examination.


I hereby certify that the aforementioned person is fit for performing strenuous physical activity including the exhausting pilgrimage to Sabarimala.  

Date

Time

Name of the Medical Officer

Designation

Registration Number

Seal

 



NB: The attached COVID 19 results should be performed within 48 Hours prior to obtaining of consultation. The certificate is valid for 48hrs from the date of issue.


Download the Certificate in Word Format from here source