Indian Oil Corporation Ltd.

Guidelines and Criteria for Physical Fitness for Pre-Employment Medical Examination
1. AIM
1.1. The aim of these guidelines is to select for a particular post/position a person who
must be in good physical and mental health and must be free from any physical defect
or disability that is likely to interfere with efficient performance of the duties and/or
safety of plants, machinery or co-workers during the course of his
service/engagement with Indian Oil Corporation Ltd (IOCL).
2. SCOPE:
2.1. Any person being considered for appointment in any post in Indian Oil Corporation
Limited whether in permanent, trainee, tenure, temporary or on deputation and also
a person being considered for engagement with the Corporation as Graduate
Apprentice Engineer (GAE) shall be required to undergo medical examination in
terms of these guidelines for being declared “FIT” for the said position.
2.2. An employee already in the service of the Corporation, who is selected for different
post, whether on the basis of open recruitment or other-wise, employees of Central
Govt., State Govt. and public-sectors joining the Corporation will also be required to
undergo medical examination under these guidelines.
2.3. Placement from non-technical functions to technical functions will require fresh
medical examination in respect of those employees who are being posted in a
technical function for the first time during the course of his/her employment.
2.4. For the purposes of Clause 2.3, Categorisation of functions/departments shall be as
under:
A. Technical Functions:
a) Refineries Division
Production, Technical Services, Quality Control, Power & Utilities, Health Safety &
Environment, Electrical Maintenance, Mechanical Maintenance, Instrument
Maintenance, Inspection, Civil Maintenance, Engineering Services, Projects,
Materials, TPM, Security.
b) Marketing Division
Operations, LPG-Engg, LPG-Ops, Lubes-Ops, Aviation, Engineering & Projects,
Quality Control, Health Safety & Environment, Cryogenics.

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 c) Pipelines Division
Operations & Maintenance, Marine/Offshore, Inspection (Metallurgy), Gas,
Technical Services, Construction, Project & Engineering, T&I, Materials, Health
Safety & Environment.
d) Research & Development Division
Alternate Energy, Analytical Division, Applied Metallurgy, Bitumen,
Nanotechnology, Lubricant Technology, Automotive Oil & ALTF, Grease and
Tribology, Industrial Lubricants, Petrochemical & Polymers, Projects and
Engineering, Petroleum Refining & Refining Technology, Hydro-processing,
Catalyst, Health, Safety and Environment, Intellectual Property.
e) Business Development Group
Exploration & Production, Petrochemicals-Ops, Gas Operations, Gas Infrastructure,
Alternate Energy, Explosives

B. Non-Technical Functions: (All Divisions)

Internal Audit, Vigilance, Contract Cell, Finance, Planning and Coordination,
Information Systems, Legal, Corporate Communications and Human Resource.
Additional Areas for Refineries Division : Medical
Additional Areas for Marketing Division : Pricing, Retail Sales, Institutional
Business, LPG-Strategy, LPG-Sales, Lubes-Sales, Lubes-TS, Supplies, Branding.
Additional Areas for R&D: Biotechnology, Modeling and Simulation, Pipeline
Research, Automotive Research.
Additional Areas for Business Development Group : Corporate Planning &
Economic Studies, Sustainable Development, Gas Sourcing, Gas Marketing,
Petrochemicals-Mktg.
The above list may undergo change/updation from time to time depending upon the
business/operational requirements.
3. PROCEDURE FOR MEDICAL EXAMINATION:
3.1. The Authority issuing an offer of appointment to a candidate joining the services of
the Corporation or accepting engagement as Apprentice, shall attach the format
prescribed for undertaking the medical examination. Medical Examination, as per
the said format will be mandatory.
3.2. Candidate offered appointment/engagement shall be required to paste his/her recent
passport size photograph in the space provided in the format at the time of
undergoing medical examination. The photograph shall be mandatorily signed and
stamped by the examining Doctor. The signature of the candidate shall also be
attested by the examining/certifying doctors.
3.3. Examining doctor shall also get the fingerprint impressions of all the fingers of the
left hand of the candidate in the space provided for the same and ensure that the
candidate puts his/her signature in the space(s) provided, before himself signing the
certificate. In cases where medical examination is conducted by Corporation’s
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 Medical officer(s), the same shall also be signed by the Chief Medical Officer of the
Unit.
3.4. Formats/Certificates not meeting the requirements mentioned at 3.2 and 3.3 shall be
rendered invalid.
3.5. Medical Examination as prescribed under these guidelines will be conducted by
Corporation’s Medical officer(s), by a Doctor in a Government Hospital not below
the rank of Civil Surgeon or by an Authorised Medical Officer of a Hospital
nominated by the Corporation, who shall be the only competent authorities to certify
a candidate as Medically Fit/Unfit/Temporarily Unfit. IOCL reserves the right to re-
examine or review any medical report. If the pre-employment medical examinations
are conducted by other than Corporation’s Medical Officer, the reports will again be
physically verified by the Corporation’s Medical Officer/Empanelled/Retainer
doctor at the time of joining of the candidate before he/she is finally declared
medically “FIT/UNFIT”. Corporation’s Medical Officer/Empanelled/Retainer
doctor may advice to repeat one or more clinical tests, as deemed fit, based on the
candidate’s clinical assessment. The decision of Corporation’s Medical
Officer/Empanelled/Retainer doctor with regard to Fitness of any candidate in
respect of any position will be considered as final.
3.6. Where facilities for conducting certain medical examination/tests are not available,
at the discretion of the examining medical authority, the candidate will be referred to
a competent medical practitioner/specialist/laboratory for getting the same done as
per the format prescribed.
3.7. In cases where medical examination/tests are conducted on advice of designated
authority and for which payment for examination/tests has been made by the
candidate, Corporation shall reimburse the charges for consultation & tests on
production of necessary money receipts, irrespective of the candidate being found
medically “FIT/UNFIT”. However, such reimbursement will be restricted to the
approved standard norms of the Corporation.
3.8. The Authorised Medical Officer(s) will complete the pre-employment medical
examination fitness certificate as given in the Pre-Employment Examination in the
formats prescribed declaring the candidate “FIT” or “UNFIT” or “TEMPORARILY
UNFIT”, as the case may be. If the pre-employment medical test is conducted at any
of IOCL’s hospital/ medical facilities, the medical department will retain the medical
report for Occupational Health Records.
3.9. Where a candidate is found to be temporarily unfit by reason of short term sickness
which is curable within a period of not more than 3 months [excluding tuberculosis
and leprosy (Hansen’s Disease) cases], the candidate will be informed by Medical
department for re-examination in the prescribed form. The reasons for being declared
temporarily unfit shall be recorded by Medical Department in Pre-Employment
Examination in the format prescribed. The examining Medical Officer may advise
the candidate to appear for re-examination after a specific period (not exceeding 3
months, except tuberculosis and leprosy cases) depending on the nature of ailment.
Upon re-examination, the examining doctor, on satisfying himself that the short-term
reason for unfitness is rectified, will declare the candidate to be medically Fit. Upon
re-examination, if a candidate is still found to be medically un-fit, the examining

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 Medical Officer may advise a new date (not exceeding maximum 3 months from the
date of first examination) for re-examination.
3.10. Where a Person with Benchmark Disability (PwBD) is selected, he/she may be
declared "PwBD but fit" if,
3.10.1. Except for the benchmarked disability, he/she satisfies all other physical
standards as prescribed and
3.10.2. Considering the nature of duties and responsibilities of the job, location,
hazard, strain and other factors, the disability is not likely to interfere with
the performance of duties of the post with reasonable efficiency and without
possible deterioration of his/her health.
3.10.3. Any change in the nature of the job of this category will require re-medical
examination for ascertaining suitability of the candidate for the job.
3.11. Detailed history of the candidate will be recorded in the medical examination forms
which will include Personal history, Family history, Occupational history and Past
history of previous illnesses, accidents and surgeries.
3.12. Defects if any, Congenital or Acquired, will be recorded in the medical examination
forms, with a clear opinion as to whether it is likely to interfere with the efficient
performance of the duties for which the candidate is under consideration for
employment/engagement.
3.13. Medical examination report in the prescribed format for all candidates shall be filled
by the examining doctor. In case of Refinery Hospital, the report shall be sent to the
concerned HR Head of the Unit/Region. The Head of HR shall suitably inform the
candidate the findings of the medical examination in the format prescribed, with
advice as may be necessary based on the candidate being found fit or unfit or
temporarily unfit.
4. GENERAL EXAMINATION
The following shall be important parameters to be considered by the Examining Doctor:
4.1. Chest: Minimum in full expiration 79 cm for male, minimum expansion 4 cm (not
applicable to female candidates)
4.2. Blood Pressure: Normotension < 140 mm of Hg. SBP and < 90 mm of Hg. DBP.
Candidate diagnosed as Hypertensive will be further investigated. Abnormal Blood
Pressure causing adverse effect on target organs shall be a disqualification.
4.3. Adenopathy: Any Lymph-adenopathy should be thoroughly investigated to rule out
any chronic Granulomatous disease like Tuberculosis, Sarcoidosis and Blood
Dyscrasias.
4.4. Heart: Dextrocardia without any symptoms per se is not a disqualification for
employment, however presence of other congenital anomalies should be examined,
and decision for fitness should be taken accordingly.
4.5. Eyes: Fundus examination should be carried out by Ophthalmologist.
4.5.1. Colour Vision: Colour vision including pink colour perception shall be
tested in good normal light for all candidates through Ishihara test or any
other recognized/admissible test including Pink perception test.

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 4.5.2. Candidates with Partial/Full Colour Blindness can be taken in Non-
Technical functions.
However, Color Blindness will be considered as disqualification for all Technical Functions
positions and also for Drivers.
4.6. Hearing: A candidate should be free from any progressive disease of the ear and
necessary audiometer tests shall be carried out to determine the same.
Audiometric screening to measure the pure tone air conduction and bone conduction
hearing threshold must be done for each candidate so that a baseline data remains for
further reference.
4.7. Pregnancy: Pregnant candidates, at the time of medical examination, will not be
barred from joining, if found FIT in all criteria mentioned in the PEME guidelines
except those that are affected due to pregnancy.
The candidate will be required to undergo a fresh medical examination, 3 (three)
months after delivery or maximum period of 12 (twelve) months from the date of
original medical examination. In case of miscarriage, the period of re-examination
would be 8 (eight) weeks after miscarriage.
Re-examination would be of only those criteria of fitness that were exempted
earlier.
The following tests/examinations of the PEME guidelines shall not be insisted
upon at the time of joining

1. Radiological examination (Clause 4.9 of the PEME guidelines)

2. Lung Function test (Clause 4.12 of the PEME guidelines)
3. Weight (Clause 6.2 of the PEME guidelines)
4. Genito Urinary System (part of Form B of PEME format)
5. Test specifically done for female candidates (part of Form B of PEME format)
However, upon joining and after the specified time period (3 months extended
upto12 months if required or 8 weeks as the case may be), such candidates would
undergo the above-mentioned tests and their continuance in service would depend
upon their qualifying as ‘FIT’ as per the laid down guidelines for these tests as per
the extant PEME guidelines.
4.8. Urine: If albumin, sugar or any other abnormality detected, further laboratory test
will be conducted to determine the cause.
4.9. Radiological Examination: Fresh x-ray chest (PA View) is must for all candidates.
The examining Doctor shall order/conduct any other radiological investigation that
shall be required/ felt necessary. Reports of all Radiological investigations must be
within normal limits.
4.10. Central Nervous System: Tests for Central Nervous System should be carried out
for all candidates. To be observed for – Sensory System, Motor System, Reflexes,
Coordination, Gait and Tremor.
4.11. Mental Status Examination: To be observed for Appearance, Behavior, Mood,
Thought Process.

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 4.12. Lung Function Tests: These will be done for all candidates.
4.13. BT (Bleeding Time) and CT (Clotting Time) shall be done if felt necessary for
reasons to be recorded in writing
4.14. Other investigations: Biochemical tests, ECG, Ultra-sonography of whole abdomen
and other special investigations will be done as per routine and any deviations from
the normal limits will be properly investigated to rule out any disease condition and
before declaring the candidate Fit.
5. TEMPORARY UNFITNESS
Candidates will be declared Temporarily Unfit for following conditions, for a period not
exceeding a maximum period of 3 months from 1st examination [except cases of
tuberculosis and Hansen’s disease (leprosy)]:
5.1. Hernia
5.2. Hydrocele
5.3. Haemorrhoids
5.4. Phimosis
5.5. Tuberculosis (upto a maximum of 12 months)
5.6. Gall Stones
5.7. Renal Stone
5.8. Dyslipidemia
5.9. Perforation of Tympanic Membrane and CSOM
5.10. Leprosy (Hansen’s disease) (upto a maximum of 12 months)
5.11. Veneral diseases till detailed examination of urethral smear and serological test
proves negative.
5.12. Any other condition, which the doctor feels, is curable within 3 months.

Candidates who have been declared Temporary Unfit, have to be re-tested to determine
fitness and an expert opinion to be established on whether the above applicable conditions,
would not result in complications leading to reduced ability to perform the assigned tasks.

6. DISQUALIFICATIONS: Following will be considered as disqualification: -

6.1. Height:
For Males -- Height less than 147.0 cm (Relaxable by 5 cms. in case of
Garhwalis, Assamese Gorkha)

For Females -- Height less than 142.5 cm (Relaxable by 2.5 cms. in case of
Garhwalis, Assamese Gorkha)

(However, any height less than 147 cms should be investigated for Dwarfism. It is
to be ascertained that the short-height is not due to any endocrinal disease or medical
anomaly or other genetical reasons.)

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6.2. Weight:
6.2.1 Weight less than 40 Kgs.
6.2.2 BMI beyond 30 with systemic involvement for candidates upto 35 years of age
BMI beyond 32 with systemic involvement for candidates above 35 years of age
6.3. Chronic diseases
6.3.1. Candidates with chronic/pre-cancerous lesions of mouth/oral cavity will be
extensively examined to rule out effect on target organs.
6.3.2. Candidates having virus infections or other conditions resulting in parameters
found in medical tests beyond normal range may be declared temporarily unfit
for a specified period of time maximum upto 3 months (excluding tuberculosis
and leprosy). Such candidates may be re-tested to determine chronic infection
and an expert opinion established whether such chronic infection may result in
complications leading to reduced ability to perform the assigned tasks.
6.4. Hypertension causing adverse effect on target organs (Left Ventricular Hypertrophy/
Hypertensive Retinopathy/ Hypertensive Nephropathy or any other related
condition)
6.5. Ischaemic Heart Disease.
6.6. Organic/Valvular/Congenital Heart Disease or any chronic heart disease with
definite clinical signs & symptoms. Benign Cardiac Arrhythmia will not be a
disqualification. However, in case of doubt, further investigations to be carried out.
6.7. Bronchial Asthma: Uncontrolled Bronchial Asthma with adventitious sound – only
for Technical Functions.
6.8. Chronic Obstructive Pulmonary Disease (COPD), Stage III or above.
6.9. History of Lobectomy/Pneumonectomy.
6.10. Seizure disorders, Parkinsonism, Ataxia, Psychosis or any other Major Neurological
Disorder.
6.11. Cirrhosis, any Hepatic progressive deteriorating condition which may lead to long
term illness & ultimately lead to Hepatic failure
6.12. Chronic renal failure
6.13. Candidates possessing single functional kidney, will not be disqualified if the single
kidney is functional at 80 % or above. Such cases have to be evaluated for CT-KUB
region, Renal Function Test, HBA1C (Glycosylated Hemoglobin), DTPA
Renogram. A clearance certificate from Nephrologist will also be required.
6.14. Deformity of Spine or any limb, congenital or acquired that will impediment efficient
discharge of duties.
6.15. Hypertension – Abnormal Blood Pressure causing adverse effect on target organs
shall be a disqualification
6.16. Diabetes with complications e.g. Macro and Micro vascular complications,
Nephropathy, Retinopathy, Neuropathy etc.
6.17. Thyrotoxicosis and Pituitary disorders.

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6.18. Ear:
6.18.1. Unable to hear whispering voice at a distance of 2 feet in both ears.
6.18.2. Decreased hearing of sensorineural or conductive type 50 dB or more at 4000
Hz upto 35 years of age in both the ears (Noise induced hearing loss)
6.18.3. Decreased hearing of sensorineural or conductive type 60 dB or more at 4000
Hz beyond 35 years of age in both the ears (Noise induced hearing loss)
6.18.4. AB gap more than 50 dB for all age groups in both ears.
6.18.5. Bilateral Nerve Deafness above 60 dB should be considered disqualification
for all categories
6.19. Eye:
6.19.1. Visual Acuity for Both eyes: Visual Acuity outside the Range below (with or
without glasses/contact lense/IOL/Implantable contact lenses):
a) For Technical Functions :
Age Distant Vision Near Vision
Better Eye Worse Eye Better Eye Worse Eye
6/9 6/9
Below 35 Yrs or Sn / 0.6 Sn / 0.6
6/6 6/12
6/12 6/12
35 Yrs and
or Sn / 0.6 Sn / 0.6
more
6/9 6/18
b) For Non -Technical Functions :
Age Distant Vision Near Vision
Better Eye Worse Eye Better Eye Worse Eye
6/12 6/12
Below 35 Yrs or Sn / 0.6 Sn / 0.6
6/9 6/12
6/18 6/18
35 Yrs and
or Sn / 0.6 Sn / 0.6
more
6/12 6/24

6.19.2. Fundus
a. Any progressive pathological condition
b. Vitreous or Choriorentinitis
c. Any Retinal disease in Diabetes, Hypertension, Atherosclerosis
d. Corrected Myopia (including the cylinder) and Hypermetropia in each eye:

Upto 35 Years Beyond 35 Years

Technical Function (-) 6 D (+) 4 D (-) 6 D (+) 6 D
Non Technical Function (-) 7.5 D (+) 4 D (-) 7.5 D (+) 6 D

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 6.19.3. Colour Blindness – Partial or Total - For Technical Function positions and
Drivers
6.19.4. Night blindness for Technical Function positions and Drivers
6.19.5. Presence of Squint leading to refractive error/ vision impairment for Technical
Function positions and Drivers
6.19.6. One Eye functional: For Technical Function positions and drivers
6.19.7. Glaucoma
6.20. Candidates with Chronic debility and Atypical infections.
6.21. Skin :
6.21.1. Oil Acne and Occupational dermatoses – Only for Technical Functions
6.21.2. Pemphigus
6.22. Malignancy of any type.
6.23. Any Collagen disease like SLE, Polyarteritis nodosa and Wegenier’s
Granulomatosis. ANA Test to be carried out for elimination of chances of collagen
diseases.
6.24. Auto-immune diseases
6.25. Any organ damage involving Heart, Lung, Liver, Kidney, Brain.
6.26. Blood dyscrasias, Coagulation disorder Sickle Cell, Hemophilia, and Thalassemia
Major.
6.27. Mental retardation
6.28. Any organ transplant except corneal transplant.
6.29. Adenopathy – any chronic Granulomatous disease like Tuberculosis, Sarcoidosis
7. RECRUITMENT FOR FIRE & SAFETY :
In addition to the other physical and medical standards applicable to candidates for
Technical function, persons to be recruited for Fire & Safety will have to additionally meet
the following physical and medical standards :
7.1 Height :
Male : Minimum 165 cms. (Relaxable by 5 cms in case of Garhwalis, Assamese
Gorkha and members of Schedule Tribe)
Female : Minimum 157 cms. (Relaxable by 2.5 cms in case of Garhwalis, Assamese
Gorkha and members of Schedule Tribe)
7.2 Chest :
Male : 81cms Unexpanded and 86 cms Expanded (Fully expanded with minimum 5
cms Expansion)
7.3 Weight :
Male : Minimum 50 Kgs.
Female : Minimum 46 Kgs.
Disqualification :
BMI beyond 28 with systemic involvement for candidates upto 35 years of age
BMI beyond 30 with systemic involvement for candidates above 35 years of age

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 7.4 Medical Standards : For both Male and Females :
a. Vision – Better Eye – 6/6 without aid (Eligible vision – 6/6 only) Worse eye – 6/12
b. No Colour Blindness
c. No Night Blindness
d. Must not have knock knee, flat foot, squint eyes and stammering
8. RECRUITMENT OF PERSONS WITH DISABILITIES
8.1. Persons with following Benchmark Disabilities
8.1.1. Blindness and low vision
8.1.2. Deaf and hard of hearing
8.1.3. Locomotor disability including cerebral palsy, leprosy cured, dwarfism, acid
attack victims and muscular dystrophy
8.1.4. Autism, intellectual disability, specific learning disability and mental illness
8.1.5. Multiple disabilities from amongst persons under clauses 8.1.1 to 8.1.4 including
deaf-blindness
And with prescribed induction level qualification except Fire & Safety may be recruited
against an identified post in Non Technical Services and all other work areas as per fair
assessment of his/ her ability/ disability provided:

8.1.6. The candidate except for the handicap must be within the normal range of all
other physical standards, prescribed for the identified post.
8.1.7. The Division/Unit shall identify the posts in respective areas, where a person,
with disability, and selected as an officer/non-officer, can be posted upon
recruitment/promotion.
8.1.8. The identified posts shall be such where a PwBD can perform his/her duties with
reasonable efficiency and without undue physical strain or hazard.
8.1.9. The nature of duties and responsibilities of the job, location, hazard, strain and
other factors will not lead to possible deterioration of his/her health.
8.1.10. Any change in the nature of the job of this category will require re-medical
examination for ascertaining suitability of the candidate for the job.
9. LIABILITY TO DECLARE
9.1. A candidate found “UNFIT” for a position during medical examination by any other
location/refinery unit of the Corporation or a Govt. Authority or any other PSU, shall
be required to declare his medical condition with reasons for being declared
“UNFIT” if the candidate applies/seeks employment/engagement at any other
location/post of the Corporation. Suppression of such information, may render a
candidature liable for rejection.
10. APPEAL:
10.1. If a candidate is not satisfied with the outcome of the medical examination, the
candidate may apply to the appointing authority for reconsideration. If the appointing
authority is satisfied that there should be a review, reconsideration / re-examination,
a medical board will be constituted consisting of- (a) The Head of the Medical
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 department of the unit, (b) One Doctor of the Corporation, (c) One concerned
Specialist and (d) One Government Doctor not below the rank of District Chief
Medical Officer or his representative.
10.2. The application for reconsideration is to be submitted within two weeks from the
communication of the result of the medical examination to the candidate.
10.3. A sum of Rs. 2000/- (Rs. Two thousand only) is to be deposited with the Corporation
by the candidate for reconsideration/re-examination. This amount will be refunded,
only if the candidate is declared fit on re-evaluation by the medical board.
10.4. All expenses on travel, accommodation etc. in connection with re-examination will
be borne by the candidate if declared “UNFIT” by the Board.
10.5. The decision of the board will be final and binding on both the parties.

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 -Form A

ANNEXURE-I

INDIAN OIL CORPORATION LIMITED

PRE-EMPLOYMENT MEDICAL EXAMINATION FORM – PART- I

Ref. No.
Candidate to
paste recent
passport size
Post considered for: photograph
duly attested
by self and
Name in full: examining
doctor
( in Block Letters)

Date of Birth

Sex

Father / Husband's
Name

Mother’s Name

Address

Identification Mark:

(I)___________________________________________________

_____________________________________________________

(II)__________________________________________________

_____________________________________________________

Date: Signature of Candidate

Signature of Examining Doctor :

*Photograph and signature of the candidate to be attested by the examining doctor

1/8
 TO BE FILLED IN BY CANDIDATE BEFORE MEDICAL EXAMINATION

Permanent Address Present Address

________________________________ _______________________________
________________________________ _______________________________
________________________________ _______________________________
________________________________ _______________________________

Answer all Questions: Put (√ ) Mark in the Column 'Yes' / ' No'

Sl. No. Question Yes No

1 Are you on any prolonged medication?
If Yes, specify:

2 Are you allergic to any medicine?

If yes, specify

3 Do you suffer from any of the following

 High Blood pressure
 Heart Disease
 Tuberculosis
 Stroke (Paralysis due to Haemorrhage in brain)
 Diabetes
 Mental illness
 Cancer
 Any other disease, please specify:

4 Do you take alcoholic beverages / intoxicants?

5 Do you smoke or take tobacco?
If yes, how much every day?

6 Do you have fainting spells?

7 Do you become unusually short of breath when you walk

upon flight of stairs?
8 Have you had a cough that started in the last 6 months &
remained more than a month?
9 Have you ever vomited or coughed out blood?

10 Do you have weakness or paralysis of either of your arms or

legs?
11 Do you ever feel so depressed that it interferes with your
jobs or with your doing house work?

12 Do you feel that you need medical or psychiatric help

because of nervousness?
13 Have you ever been rejected in Pre Employment Medical
Examination.

Date: Signature of Candidate

2/8
 If yes, name of the company, where you got appointment :

14 Do / Did any of your family member(s) suffer(ed) from any of

the following:
 High Blood pressure
 Heart Disease
 Tuberculosis
 Stroke (Paralysis due to Haemorrhage in brain)
 Diabetes
 Mental illness
 Cancer

15 Do you have Hernia / Piles / Hydrocele?

16 Please specify significant information, if any, not covered above:

Marital History : Single / Married / Widowed / Widower / Divorced

No. of Children: Male _____________ Female ______________
F P History : Vasectomy / Tubectomy

Immunization: Tetanus Toxoid: I II III Booster: I II

Hepatitis B : I II III

PAST EMPLOYMENT, IF ANY:

NAME OF COMPANY NO. OF NATURE OF JOBS ANY OCCUPATIONAL

YEARS HEALTH AILMENT

Whether Found Medically FIT/UNFIT

Details of the Ailments

DECLARATION BY THE CANDIDATE:

I declare that the above information is true and correct to the best of my knowledge and belief.

Date: _________________
Place: _________________ Signature of Candidate

FINGER PRINT OF LEFT HAND FINGERS

Little Finger Ring Finger Middle Finger Index Finger Thumb

Date: Signature of Examining Doctor

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 Form B
PRE-EMPLOYMENT EXAMINATION PART – II
(to be filled by the Doctor)

GENERAL EXAMINATION:
HEIGHT: _____________ CM WEIGHT: ______________ KG BMI__________________
CHEST: INSPIRATION __________ CM. EXPIRATION: ____________CM.
BUILT – AVERAGE/ STRONG/ POOR
THROAT __________ TONGUE __________ TONSILS ________________
__
TEETH________ GUMS _________ THYROID_______________________
LYMPH NODES _______________________________________________________
_
ADDITIONAL FINDINGS _______________________________________________________

CARDIO-VASCULAR SYSTEM:

PULSE: ___ / MIN. REGULAR/ IRREGULAR PERIPHERAL PULSE – FELT/ NOT FELT
B.P. ___________ mm of Hg.
HEART SOUND: ______________________________________________________________
MURMUR, IF ANY: ____________________________________________________________
ADDITIONAL FINDING (S), IF ANY-_______________________________________________

RESPIRATORY SYSTEM:
SHAPE OF CHEST: ___________________________________________________________
CHEST MOVEMENTS: ________________________________________________________
TRACHEA: __________________________________________________________________

BREATH SOUNDS: ___________________________________________________________

GASTRO-INTESTINAL SYSTEM:
LIVER: ____________________________ SPLEEN: ____________________________
ANY ABDOMINAL LUMPS: _____________________________________________________

EXAMINATION OF EYES:
EXTERNAL EXAM. ________________________ SQUINT: _______________________
NYSTAGMUS: _______________________________________________________________
COLOUR VISION – NORMAL/ DEFECTIVE
FUNDUS (L) (R)

INDIVIDUAL COLOUR IDENTIFICATION – NORMAL/ DEFECTIVE

DISTANT VISION (WITHOUT GLASSES)

RIGHT ____________________________ LEFT ___________________________________
(WITH GLASSES) RIGHT _____________________ LEFT __________________________

Date: Signature of Examining Doctor

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 NEAR VISION (WITHOUT GLASSES)
RIGHT __________________________ LEFT ________________________
(WITH GLASSES) RIGHT _______________ LEFT ____________________
POWER OF GLASSES _______________ CONTACT LENSES _________________
NIGHT BLINDNESS: (NYCTALOPIA): ____________________________________________

PINK PERCEPTION TEST :____________________________________________________

EXAMINATION OF EAR, NOSE &THROAT:

EXTERNAL EXAM: __________________________________________________________
AUROSCOPY – RIGHT ______________________ LEFT ______________________
TUNING FORK TESTS –
RINNES TEST _________________________ WEBERS TEST ___________________
CONVERSATIONAL HEARING / WHISPERING: ___________________________________

AUDIOMETRY(AIR AND BONE CONDUCTION)____________________________________

GENITO URINARY SYSTEM:

(NOT FOR PREGNANT LADIES – refer clause 4.7 of PEME guidelines)
HERNIA: _____________________ HYDROCELE/ VARICOCELE __________________
CRYPTORCHIDISM ______________ PHIMOSIS ___________________________
VARICOSE VEINS _____________ SIGNS OF STD _____________________________

FOR FEMALE CANDIDATES

(NOT FOR PREGNANT LADIES - refer clause 4.7 of PEME guidelines)

MENSTRUAL HISTORY OBSTETRIC HISTORY

MENARCHE AT _________ YRS. GRAVIDA ___________ PARA ____________

LMP - ______________________________________________________________________

PELVIC EXAMINATION ( FOR MARRIED WOMEN ONLY)

VULVA :__________ VAGINA: __________ URETHRA: _________ CERVIX__________

UTERUS: __________________________ ADNEXA: _____________________________

PAP SMEAR: _______________________ PREGNANCY TEST: _____________________

Date: Signature of Examining Doctor

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 INVESTIGATIONS

LAB INVESTIGATIONS:

URINE: ALBUMIN __________________________ SUGAR ___________________________

MICROSCOPY ______________________ STOOL: __________________________
HAEMOGRAM
Blood Group:_______ Rh factor:_______ Hb _______ TLC _______ RBC _________
E M B Platelets Count
DLC – P L ________________________________
LIPID PROFILE
Serum cholesterol: S/Triglycerides
HDL LDL

HEPATIC PROFILE
SGPT: SGOT:
Alkaline Phosphatase:

RENAL PROFILE
Blood Urea: S/Creatinine:

METABOLIC
Blood Sugar – F: Blood Sugar – PP: S/uric acid:
Bleeding Time: Clotting Time:

OTHERS
VDRL:

OTHER INVESTIGATIONS:
X-Ray Chest ___________________________________________________________________
Ultrasound Whole Abdomen _______________________________________________________
ECG __________________________________________________________________________
_
Central Nervous System _________________________________________________________

Mental Status Examination ________________________________________________________

Others:________________________________________________________________________

PULMONARY FUNCTION TEST

FVC FEV 1

Predicted

Measured

% of Predicted

Remarks:

Date: Signature of Examining Doctor

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 AUDIOGRAM

500 1000 1500 2000 3000 4000 6000 8000

-10
0
10
20
30
40
50
60
70
Hearing Loss In dB

80
90
100
110
120
130

Frequency in Hz

AIR CONDUCTION BLUE LT EAR X 0 RED RT EAR

BONE CONDUCTION BLUE LT EAR > < RED RT EAR

ADDITIONAL INVESTIGATION FOR MORE THAN 35 Yrs. OF AGE (MALE):

1. TMT
2. ECHO
3. U/S PROSTATE

Date: Signature of Examining Doctor

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 Form C
PRE-EMPLOYMENT EXAMINATION PART- III

Medical Certificate

We hereby certify that Shri / Smt. / Kum _____________________________________,

a candidate for appointment in Indian Oil Corporation Limited, ____________________,
as _________________ at________________ has been examined by us, we cannot
discover that he / she has got any disease, communicable or otherwise, constitutional or bodily
deformity except ______________________________________.

We do/do not consider this as disqualification for the above post as per Clause No.______

He/ She is hereby declared, for the above post, as:

FIT UNFIT TEMPORARILY UNFIT

Signature of Examining Doctor Signature of Chief Medical Officer

or Civil Surgeon/Authorised Medical
Officer of Nominated Hospital
Name: Name:
Registration No. Registration No.
Date: Date:
Seal: Seal:

FOR USE OF IOCL’S DOCTOR/IOCL EMPANELLED DOCTOR

Shri / Smt. / Kum _________________________ does/does not have any congenital or acquired defects to

interfere in efficient performance of the duties by the candidate.

FIT UNFIT TEMPORARILY UNFIT

Remarks

Date: Signature of Competent Medical Authority

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