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MEDICAL / SICK LEAVE CERTIFICATE
Parent Name: ROLANDO JR LLAMIDO BULAWIN Over ID: ‘6a240N908
Te Number: HC04596301 Onder Date: ore n/2021 1720
Date Orin: VFEBISTS Eacountr 1D: 0108238736
Gender; Male [Admission Visit Date: O2/FEB/2021 10:40
aw, 27560820007 pected Discharge Date: 02FEB/2021
Passport No Modical Service Emergency Medicine
anally: Pipe act Hamad General Hospital
‘Reason for Visit / Diagnosis
Primary Dingnosis; Dog bite
‘Special Instructions / Comments (Any
Effective from: OMFEB2N21_ to _ONFEB/2021
Practitioner / Facility Details
Praciioner Name De Saidatut Amsinah Bint Osman — 041542 — Spectallt ~ Emengeney Medicine
Corporation /QCHP No: O41S42/ P8887
‘Signature Line
Becrorcally Signed on OD/FEI2021 17:20
Dr. Saiatul Aminah Bioti Onman ~ 041542 ~ Specialist ~ Emergensy Medicine ~
ad ds mot require PHYSICIAN Signature and FACILITY Stamp,
jorganization School within 7 days
sho orespond to the ptine
Layagan ~ 453372 — Covid Volumeer Nurse Pai
Date : O2FEB/2021 17:34:41