89. [ [This amended rule may be deemed to have come into into force from 1-7-1978.]
Before a gazetted government servant can be granted leave, or an extension of leave on medical certificate, he/she must obtain a certificate in the following form:]Statement of the case of .............Name (to be filled in by the applicant in the presence of the Chief Medical Officer or the authorised medical attendant).Appointment heldAgeTotal servicePrevious periods of leave of absence on medical certificate.HabitsDiseaseHistoryI .................... Chief Medical Officer/ Authorised Medical Attendant at ............... or of ............... after careful and personal examination of the case hereby certify that Shri/ Shrimati/ Kumari ............... is in a bad state of health and I solemnly and sincerely declare that, according to the best of my judgement, a period of absence from duty is essentially necessary for the recovery of his/her health and recommend that he/she may be granted leave for ............... with effect from ...............*In my opinion it is/it is not necessary for the office appear before a medical board.Chief Medical Officer/AuthorisedMedical Attendant.Dated .............*This sentence should either be modified by scoring out the irrelevant words or altogether scored out according as the period of leave recommended is up to three months or exceeds that period.Note - (1) This form should be adhered to as closely as possible and should be filled in after the signature of the government servant applying for leave has been taken. The certifying officer is not at liberty to certify that the applicant requires a change from or to a particular locality or that he/she is not fit to proceed to a particular locality. Such certificate should only be given at the explicit request of the sanctioning authority to whom it is open to decide when an application on such grounds has been made to him, whether the government servant should go before a medical board to decide the question of his/her fitness for service.Note - (2) The medical certificate and history of the case as also the certificate prescribed in rule 91 or 94(b), as the case may be, should be prepared in duplicate, one copy of which the government servant proceeding on leave should take with him/her for presentation to the medical board or officer who examines him/her for fitness before his/her return to duty.
