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Form Certificate of Disability (In cases of amputation or complete permanent paralysis of limbs or dwarfism and in case of blindness) See rule 18(1) (Name and Address of the Medical Authority issuing
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How to fill out in cases of amputation

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First, make sure to consult with a healthcare professional for guidance specific to your situation.
02
Start by gathering all the necessary medical documents and information related to your amputation, including any previous surgeries or treatments.
03
When filling out the forms, provide accurate and detailed information about your medical history, the reason for amputation, and any complications or ongoing treatments.
04
Include any medications you are currently taking or have taken in the past, as well as any known allergies or adverse reactions.
05
If applicable, indicate any assistive devices or prosthetics you use or may need in the future.
06
When describing your daily living activities, be honest about any limitations or challenges you may face as a result of the amputation.
07
If necessary, seek assistance or support from a healthcare professional or counselor when completing the forms.
08
Double-check all the information provided before submitting the forms to ensure accuracy and completeness.

Who needs in cases of amputation?

01
Individuals who have undergone amputation due to medical conditions or injuries.
02
People who require medical assistance, rehabilitation, or prosthetic devices to compensate for the lost limb.
03
Those who may benefit from financial, legal, or social support services available for individuals with disabilities resulting from amputation.
04
Family members or caregivers of individuals who have undergone amputation may also need guidance and support.
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In cases of amputation, a body part is surgically removed.
Employers are required to file in cases of amputation.
The form for reporting cases of amputation must be filled out completely and accurately.
The purpose of reporting cases of amputation is to ensure workplace safety and prevent future incidents.
Information such as the type of injury, affected body part, and details of the incident must be reported on in cases of amputation.
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