MEDICAL CERTIFICATE
Signature of applicant …………………………
I (Name)………………………………………………………………………………..
………………………………………………………………………………………….
…………………………………………………………….. (Name & Official Address)
after careful personal examination of the case hereby certify that ……………………..
………………………………………………………. Whose signature is given above
is suffering from …………………………………………………………………………
and that I consider that a period of absence duty of …………………………………….
With effect from …………………………………………………………………………
Is absolutely necessary for the restoration of his/her health.
Place Signature of Medical Officer
Registration No.
Date Part of Registration
System of Medicine