SELF DECLARATION FOR MEDICAL FITNESS

I, _______________, the undersigned hereby declare that I do not suffer from any serious health ailments that would affect my ability to perform the tasks assigned to me. I hereby willfully agree that the company shall not be liable for any compensation in case the declaration is found to be false or incorrect.

I hereby declare that the information provided is true and correct to the best of my knowledge. I have authenticated the information given in the document with my signature below.

Name of the employee:

Signature of the employee:

Date of signing: