It may be said that railways have made the language of the revised
format ambiguous. The idea of this format is to have a single format
for all physical / mental impairments rather than separate certificate
based on the disability.

Text as produced by OCR below for your reading:

Concession certificate form for orthopaedically handicapped/paraplegic
person/patients/mentally retarded person  /completely blind
person/totally deaf & dumb person

Paste passport  Size photograph

Duly signed  And stamped by  The issuing doctor

This is to certify that KM/Shri/Smt
whose particulars are furnished below is a  bonafied ORTHOPAEDICALLY
HANDICAPPED/PARAPLEGIC PERSON/PATIENTS WHO CANNOT  TRAVEL WITHOUT THE
ASSISTANCE OF AN ESCORT/MENTALLY RETARDED PERSON WHO  CANNOT TRAVEL
WITHOUT AN ESCORT/COMPLETELY BLIND PERSON/TOTALLY DEAF &  DUMB PERSON
*

Particulars:



a) Address  b)Father's/Husband's Name

c) Age:



d) Sex

e) Nature of Handicap: (To be written  by doctor whether the
disability is  temporary or Permanent)  0 Signature or thumb
impression  of the person seeking concession(not necessary for those
with  Both hands missing or non-functional):

(Signature of Government Doctor#)  Place:  Date:

Clear seal of Government           Seal containing full name and
Hospital#                                Regn .No. of the Doctor#.

*Strike out where not applicable.  # For blind persons RMP/head of
institution for the blind recognized can also issue certificate for
blind.  Note:  1)The certificate Should be issued only to those
ORTHOPAEDICALLY HANDICAPPED/PARAPLEGIC  PERSON/PATIENTS WHO CANNOT
TRAVEL WITHOUT THE ASSISTANCE OF AN  ESCORT/MENTALLY RETARDED PERSON
WHO CANNOT TRAVEL WITHOUT AN  ESCORT/COMPLETELY BLIND PERSON/TOTALLY
DEAF & DUMB PERSON. The photo must be  signed and stamped in such a
way that doctor's signature and stamp appears partly on the photo and
partly on the  certificate.

2) For Mentally retarded persons/Completely blind persons/Deaf and
dumb persons (both afflictions together), the  certificate will be
valid for five years from the date of issue. For temporary disability
in the case of  orthopedically/paraplegic persons, the certificate
will be valid for 5 years and in case of permanent disability , the
certificate will remain valid for (i) five years, in case of persons
upto the age of 25 years, (2) ten years, in case of  persons in the
age group of 26 to 35 years and (3) in case of persons above the age
of 35 years, the certificate will  remain valid for whole life of the
concerned persons. After expiry of the period validity of the
certificate, the  person is required to obtain a fresh certificate.

3) Photocopy of this certificate is accepted for the purpose of grant
of concession. The original certificate will  have to be produced for
inspection at the time of purchase of concessional ticket and during
the journey, if  demanded.  4) No alteration in the form is permitted.

Regards,
-- 
Amar Jain.
Website: www.amarjain.com



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