ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
MEDICAL LEAVE CERTIFICATE
2
3
This is to certify that Sri/ Smt / Kum __________________________________
4
S/O, D/O ____________________________ aged about ________ years is working as
5
______________________________ in the office ______________________________
6
is in good health , besides that she / he has avail / not avail medical leave
7
from _______________ to _____________ for the past three years.
8
9
10
Signature of the Drawing officer
11
Office Seal
12
13
14
15
GOOD HEALTH CERTIFICATE
16
17
This is to certify that Sri/ Smt / Kum __________________________________
18
S/O, D/O _______________________________ Working as _____________________
19
in the office of the __________________________________ aged ( ) years, is found
20
in good health without any ailments
21
22
23
24
25
Date :
Signature of the Civil Surgeon / Civil Asst.
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100