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Printable format of the Railway concession



Concession Certificate for Orthopaedically handicapped/paraplegic persons/patients.
Form for the purpose of issue of rail concession to Orthopaedically handicapped/ Paraplegic persons/patients to be used by the Govt. Doctor/Orthopaedic Surgeon.


This is to certify that Shri/Smt__________________________________whose particulars are furnished below, is a bonafide *orthopaedic handicapped/Paraplegic person/patient and cannot travel without an escort.

Particulars of *Orthopaedically handicapped/paraplegic person/patient:
(a) Age
(b) Sex
(c) Personal identification marks


   (1)_____________________________


   (2)_________________________________


(d) Signature or left hand thumb impression of the person/patient



________________________________

(e) Nature of handicapped


_____________________________

(f) Causes of loss in functional capacity


________________________


Signature




*Government Doctor/*Orthopaedic Surgeon


Place____________       Date_____________






Seal of Hospital/Orthopaedic Surgeon


*Strike out where not applicable.

Note:

  1. The certificate is valid for three years from the date of issue and the Photostat copy or copy thereof duly attested by Gazetted Officer, a Magistrate or Member of Parliament or State Legislature shall also be accepted for the purpose of grant of concession. Certificate in original may, however, be produced for inspection at the time of purchase of concessional ticket.
  2. No alteration in the form is permitted unless attested by Issuing Officer.
  3. Certificate should be issued to Orthopaedically handicapped/Paraplegic person/patients only who cannot travel without an escort. In the case of (Orthopaedically handicapped persons, the certificate from a Govt. Doctor or an Orthopaedic Surgeon will be valid; but in the case of Paraplegic patients, the certificate from a Govt. Doctor only will be valid.


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