JAWAHARLAL INSTITUTE OF POSTGRADUATE MEDICAL EDUCATION AND RESEARCH
PUDUCHERRY – 605 006
Institute of National Importance, ministry of Health & family Welfare, Govt of India
See rule S.R. 229
MEDICAL CERTIFICATE FOR NON-GAZETTED OFFICERS RECOMMENDED FOR LEAVE
OR EXTENSION OR COMMUTATION OF LEAVE
Signature of applicant:
I, Dr. …………………………………………………………………… after careful personal examination of the case
Hereby certify that Thiru/ Tmt/ Selvi …………………………………………………………………………………………….
Of the ………………………………………………………………………………. Department, whose signature is given
Above, is suffering from ……………………………………………… and I consider that a period of absence from
duty for ………………………….. days with effect from ………………………………….. is absolutely necessary for
the restoration of his / her health.
Station: Signature:
Date: Designation:
JAWAHARLAL INSTITUTE OF POSTGRADUATE MEDICAL EDUCATION AND RESEARCH
PUDUCHERRY – 605 006
Institute of National Importance, ministry of Health & family Welfare, Govt of India
See rule S.R. 229
MEDICAL CERTIFICATE FOR NON-GAZETTED OFFICERS RECOMMENDED FOR LEAVE
OR EXTENSION OR COMMUTATION OF LEAVE
Signature of applicant:
I, Dr. …………………………………………………………………… after careful personal examination of the case
Hereby certify that Thiru/ Tmt/ Selvi …………………………………………………………………………………………….
Of the ………………………………………………………………………………. Department, whose signature is given
Above, is suffering from ……………………………………………… and I consider that a period of absence from
duty for ………………………….. days with effect from ………………………………….. is absolutely necessary for
the restoration of his / her health.
Station: Signature:
Date: Designation:
