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Students Medical Certificate Form

I took leave from college for dengue

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mohammedsabeel063
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153 views

Students Medical Certificate Form

I took leave from college for dengue

Uploaded by

mohammedsabeel063
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MEDICAL CERTIFICATE FOR LEAVE OR EXTENSION OR COMMUTATION

Signature of the Applicant:..........................................................................................................................

I, Dr...................................................................................... after careful personal examination of

the case hereby certify that Thiru/Tmt......................................................................................................

whose signature is given above, working as...................................................................................................

in the office of the .............................................................................................................................................

is suffering from..............................................................................................................based on clinical

Conditions and investigation and I consider that a period of absence from duty with effect

from..................................to........................................ for .............. days is absolutely essential for the

restoration of his/her health.

Station: Signature of the Medical Officer.

Date :

.................................................................................................................................................................

CERTIFICATE OF FITNESS TO RETURN DUTY

Signature of the Candidte..........................................................................................................................

This is to certify that I, Dr............................................................................................................

after careful examination of Thiru/Tmt./Selvi...........................................................................................

whose signature is given above, working as.............................................................................................

in the office of the ........................................................................................................................................

and I have to come to the conclusion that he/she was recovered from his/her illness and is

noe physically fit to resume his/her duties in Government service with effect from.......................................

I also certify that before arriving at this decision, I have examined the original Medical certifictes
and statements of the case on which leave was granted or extended and have taken this consideration
before arriving at my decision.

Station: Signature of the Medical Officer,

Date : Regn. No.

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