Translation ( French to English ) CERFA-NOTICE OF SICK LEAVE Initial or Extension X The Medical Details : |, undersigned certify that i did medical examination of the following patient named PATEL ALPABEN and prescribed her work stoppage and traveling until nine february 2017 Without report with infection indicated in the articals L 324-1 and R 613-69 OF THE Social Security Code (see notice nr 3) By exception for medical justified reason from 19 /08/2014 The medical element Following to the operative reason. Signature of the patient : Signed : PATEL ALPABEN Signature os the Doctor : Signed with the seal of the Hospital HOSPITAL GROUP PARIS SAINT-JOSEPH 185 Rue Raymind Losserand -75674 Paris Cedex Doctor Manuel AUBERT Institut de Neurologie Leopold Bellar N RPPS : 1000820117