Medical Certificate Form 4: Who Needs It, and How to Get It

Form 4 in Indian regulatory practice refers to several statutory medical health declarations. Most commonly, it is encountered in the Factories Act, 1948 (certificate of unfitness for young persons) and in some state-level driving licence renewal frameworks.

Form 4 under the Factories Act

When a Certifying Surgeon examines a young person and finds them unfit for factory employment — temporarily or permanently — the surgeon issues Form 4. It records the medical reasons and is forwarded to the factory inspector. This form prevents the young person from being employed against the medical advice.

Form 4 in driving licence contexts

Several state RTOs use Form 4 (along with Form 1 and Form 1A) for non-transport licence renewals where the applicant is below 40 and self-declares medical fitness. The declaration is typically counter-signed by an MBBS doctor on the RTO's panel.

When is Form 4 required?

• When a young person is found unfit for factory employment after Section 69 examination
• When the State Inspector requires reasons for revoking a Section 69 fitness certificate
• For some state-specific driving licence renewals below age 40
• For specific government health declarations referenced in state notifications

Who can issue Form 4?

The Certifying Surgeon under the Factories Act is the primary authority for the factory-related Form 4. For RTO-specific Form 4 declarations, an MBBS doctor on the RTO panel signs the form.

Validity period

For factory-related Form 4, the certificate of unfitness is reviewed annually or as directed by the Certifying Surgeon. For RTO Form 4 declarations, validity is typically tied to the driving licence renewal cycle (3–5 years).

Cost and timeline

Both forms are processed quickly at government dispensaries — usually the same day for ₹100–₹500. Private clinic costs vary from ₹500–₹1,500 depending on tests required.