Medical Certificate Format

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Medical Certificate

Date: ____________

To whom it may concern:

This is to certify that _________________________ of ________________________________


was examined and treated at the Wenlock District Hospital, Mangalore from ______________ to
_____________ with the following diagnosis:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
And would need medical attention for __________________ days barring complication.

_____________________________
(Attending Physician)

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