UK Practice: 2nd Floor, 13-15 Bouverie Street, London, EC4Y 8DP, UK Company number 8614024 Tel: +44 (0)330

088 4980
ROI Practice: 25-28 North Wall Quay, IFSC, Dublin 1, Dublin, D01 H104, Ireland Company number 689685 Tel: +353 (0)1800 719 048
SHL_CLINICAL contactus@doctorcareanywhere.com

Fit note (16/05/2023) 1/1

Patient details: Appointment details:

Name: Mr Alexandru-Gheorghe Ivanus Ref number: APP-002342683
Address: Flat 69 Brecon Lodge 2 Wintergreen Boulevard, West Drayton, Date & time: 16 May 2023, 13:40
UB79GJ, United Kingdom Doctor: Dr Ruth Hartley
Date of birth: 09 May 1989 (Age 34) GMC: 6122491
Phone: +44 (0) 7426534953
Email: alex.ivanus@gmail.com
DCA reference no.: DCA-001215222
Insurance member no.: Not Known

To:
To whom it may concern

Examination:

Examination date
16/05/2023

Condition(s)
anxiety, depression, bereavement reaction

Refrain from work between

16/05/2023 to 30/05/2023

Please also copy any further correspondence to the patient's GP

Dr Ruth Hartley ( GMC: 6122491 )

Signature: