ALEBTONG DISTRICT LOCAL GOVERNMENT

PO. BOX 316, LIRA

The District health Officer

Alebtong District

Through………………………………………………………..

ABSENCE FROM DUTY STATION

Name of officer………………………………………………………………………………………………………………………………….

Designation ……………………………………………………………………………………………………………………………………….

Reason for leaving station………………………………………………………………………………………………………………….

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Date of leaving station………………………………………………………………………………………………………………………..

Duration of absence……………………………………………………………………………………………………………………………..

Expected date of returning for duty……………………………………………………………………………………………………..

Your duty is delegated to……………………………………………………………………………………………………………………..

Officer Sign………………………………………………………………………………………………………………………………………….

Date……………………………………………………………………………………………………………………………………………………