Essentiality Certificate (IP) - II
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ESSENTIALITY CERTIFICATE
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(To be Completed in the case of Patients who are admitted to Hospital for Treatment)
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          I Certify that Mrs./Mr./Miss. _______________________________ Mother/ Father/Wife/Son/Daughter of Mrs./Mr./Miss. ____________________________ Employed in the _____________________________________________________ has been under my treatment for _______________________________________ Deceases from _________ to __________at _______________________________ Hospital / my consulting room and that the under mentioned medicines prescribed by me in this connection were essential from recovery/prevention of serious deterioration the condition of the patient. The Medicines are not stocked in the _____________________________________ Hospital (from supply to patients) and do not include proprietary preparations fro which cheaper substance of equal therapeutic value are available or preparations which are primarily foods, toilets or disinfectants.
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S.No.Name of the MedicineCost
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Total
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Counter SignedSignature and Designation of the Medical Officer In Charge of the Hospital
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ESSENTIAL (IP) - 2