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Medical Leave Certificate for Govt. Employees

The form certifies that a government employee, whose signature is included, was personally examined by an authorized medical attendant and is suffering from a condition. The medical attendant recommends the employee be absent from duty for a certain period, beginning on a specified date, for the restoration of their health. The medical attendant must sign and date the certificate, and include their role and place of practice.

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516 views1 page

Medical Leave Certificate for Govt. Employees

The form certifies that a government employee, whose signature is included, was personally examined by an authorized medical attendant and is suffering from a condition. The medical attendant recommends the employee be absent from duty for a certain period, beginning on a specified date, for the restoration of their health. The medical attendant must sign and date the certificate, and include their role and place of practice.

Uploaded by

Psycho Soldier
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

FORM No.

(See rule 17)

MEDICAL CERTIFICATE FOR GOVT. SERVANTS RECOMMENDED LEAVE OR


EXTENSION OF LEAVE OR COMMUTATION OF LEAVE

Signature of the Government servant ...........................................

I,................................................ after careful personal examination of the case


hereby certify that Shri/Shrimati/Kumari...............................whose signature is given
above, is suffering from...............and I consider that a period of absence from duty of
................with effect from...............is absolutely necessary for the restoration of
his/her health.

Authorised Medical Attendant,

.............Hospital/Dispensary

or other Registered Medical

Practitioner

Dated.....

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