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This medical certificate is from Bernardino General Hospital and certifies a patient's medical information including age, sex, status, occupation, address, findings, diagnosis, recommendations, and remarks as well as the attending physician's information and signature.

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5K views1 page

Sample

This medical certificate is from Bernardino General Hospital and certifies a patient's medical information including age, sex, status, occupation, address, findings, diagnosis, recommendations, and remarks as well as the attending physician's information and signature.

Uploaded by

hhnhoinhnhjhkj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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BERNARDINO GENERAL HOSPITAL

[ ] Quirino Highway,San Bartolome, Novaliches Q.C.


[ ] NorthOlympus, Zabarte Road, Novaliches Q.C.

MEDICAL CERTIFICATE

Date:_______________________

This is to certify that:_____________________________________________________________________________________

Age:________________Sex:________________Status:___________________________Occupation:____________________

Address:_______________________________________________________________________________________________

___________________________________________________________________________________________ is under care

Medical Care & Treatment:_______________________________________________________________ with the following

Findings:______________________________________________________________________________________________

Diagnosis:______________________________________________________________________________________________

Recommendation:_______________________________________________________________________________________

Remarks:_______________________________________________________________________________________________

________________________
AttendingPhysician

Lic No._______________
T I N ________________
FORM 06-96

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