DR.
YATHARTH SINGH SURI
M.B.B.S., GENERAL MEDICINE | REGD. NO. MP-35499
dryatharth@medicalcertificate.in | 08068507810
SICK LEAVE CERTIFICATE
ISSUE DATE: 2/04/2025 DOCUMENT NO.: MC02042025ME01566
To, Manipal University Jaipur
This is to certify that Ms. Adaa Sayed, a student and patient under my medical
supervision, underwent laparoscopic surgery for an ovarian cyst in January 2025.
She was advised strict post-operative rest and recovery measures following the
procedure.
Subsequently, in February 2025, she developed a serious bacterial sepsis
infection, for which she required immediate hospitalization and further medical
treatment under continuous observation.
Due to the nature and proximity of both medical conditions, the patient was
declared medically unfit to attend academic or physical activities during this entire
period. She was under continuous medical care and prescribed complete bed
rest, along with supportive therapy and regular follow-ups.
In view of the above, she is granted medical leave from 11th January 2025 to 2nd
April 2025, and may resume academic activities only after medical clearance.
Patient 's Signature
Ms. Adaa Sayed Dr. Yatharth Singh Suri
Patient 's Name Doctor 's Name
This medical certificate is issued based on the clinical evaluation, medical history, and diagnostic evidence presented during the patient’s consultation. It is intended
solely for academic or professional documentation purposes and is valid only for the period of medical leave specified. The certificate must not be altered,
reproduced, or misused in any form without prior authorization from the issuing doctor or institution. The patient is advised to resume academic or physical
activities only after the recommended rest period and upon further medical assessment. Any attempt to tamper with or falsify the certificate will be considered a
breach of medical and ethical standards. For verification purposes, the concerned authorities may directly contact the issuing medical professional or institution. This
certificate does not serve as a legal or insurance document unless specifically supplemented with relevant paperwork. The confidentiality of the patient’s medical
condition is to be respected in accordance with applicable privacy laws and medical ethics.
DR. YATHARTH SINGH SURI
M.B.B.S., GENERAL MEDICINE | REGD. NO. MP-35499
dryatharth@medicalcertificate.in | 08068507810
PRESCRIPTION
NAME: Ms. Adaa Sayed AGE/GENDER: 19 years/Female
ISSUE DATE: 11/01/2025 DOCUMENT NO.: MC11012025ME0145848
Complaints of:
Abdominal pain
Weakness and fatigue
Difficulty in performing routine activities
Duration of complaints:
2.5 months
Past history of similar complaints:
No
Comorbidities:
No
Course of illness:
Post-surgical recovery; gradual improvement
Any substance intake:
No
Any significant past history of disease:
No
Any history of surgery:
Yes – Laparoscopic surgery for ovarian cyst removal
(January 2025)
History of travel:
No
Family history of such illness:
No
Severity of illness:
Initially severe; currently moderate
Took Allopathic/Homeopathic/Ayurvedic medicine for
illness:
Yes (Allopathic) Dr. Yatharth Singh Suri
Took self-help and used home remedies: Doctor 's Name
Yes
This medical certificate is issued based on the clinical evaluation, medical history, and diagnostic evidence presented during the patient’s consultation. It is intended
solely for academic or professional documentation purposes and is valid only for the period of medical leave specified. The certificate must not be altered,
reproduced, or misused in any form without prior authorization from the issuing doctor or institution. The patient is advised to resume academic or physical
activities only after the recommended rest period and upon further medical assessment. Any attempt to tamper with or falsify the certificate will be considered a
breach of medical and ethical standards. For verification purposes, the concerned authorities may directly contact the issuing medical professional or institution. This
certificate does not serve as a legal or insurance document unless specifically supplemented with relevant paperwork. The confidentiality of the patient’s medical
condition is to be respected in accordance with applicable privacy laws and medical ethics.
DR. YATHARTH SINGH SURI
M.B.B.S., GENERAL MEDICINE | REGD. NO. MP-35499
dryatharth@medicalcertificate.in | 08068507810
PRESCRIPTION
NAME: Ms. Adaa Sayed AGE/GENDER: 19 years/Female
ISSUE DATE: 11/01/2025 DOCUMENT NO.: MC11012025ME0145848
Special notes by the registered medical practitioner:
Complete rest and gradual return to daily activities
Regular follow-up for healing assessment
Maintain hygiene and avoid any strenuous movement
Full Diagnosis of the illness:
Post-operative recovery following Laparoscopic Ovarian
Cystectomy
Suggested rest for 4 weeks from:
11-Jan-2025
Rx:
Tab Pan-D – 1 tab / OD (before breakfast)
Tab Taxim-O 200 – 1 tab / BD (antibiotic)
Tab Meftal-Spas – 1 tab / SOS (for abdominal pain)
Tab Livogen-Z – 1 tab / OD (for iron and recovery support)
Betadine Solution – For local wound cleaning
Protein supplement – 1 scoop daily with milk or water
Dr. Yatharth Singh Suri
Doctor 's Name
This medical certificate is issued based on the clinical evaluation, medical history, and diagnostic evidence presented during the patient’s consultation. It is intended
solely for academic or professional documentation purposes and is valid only for the period of medical leave specified. The certificate must not be altered,
reproduced, or misused in any form without prior authorization from the issuing doctor or institution. The patient is advised to resume academic or physical
activities only after the recommended rest period and upon further medical assessment. Any attempt to tamper with or falsify the certificate will be considered a
breach of medical and ethical standards. For verification purposes, the concerned authorities may directly contact the issuing medical professional or institution. This
certificate does not serve as a legal or insurance document unless specifically supplemented with relevant paperwork. The confidentiality of the patient’s medical
condition is to be respected in accordance with applicable privacy laws and medical ethics.
DR. YATHARTH SINGH SURI
M.B.B.S., GENERAL MEDICINE | REGD. NO. MP-35499
dryatharth@medicalcertificate.in | 08068507810
PRESCRIPTION
NAME: Ms. Adaa Sayed AGE/GENDER: 19 years/Female
ISSUE DATE: 27/02/2025 DOCUMENT NO.: MC27022025ME0144998
Complaints of:
High fever
Chills
Body pain
Nausea and weakness
Difficulty in daily activities
Duration of complaints:
2 weeks (February 2025)
Past history of similar complaints:
No
Comorbidities:
No
Course of illness:
Acute onset, rapidly worsening; required urgent medical attention and hospitalization
Gradual improvement under supervised antibiotic treatment
Any substance intake:
No
Any significant past history of disease:
Post-surgical vulnerability due to recent ovarian cyst surgery
Any history of surgery:
Yes – Ovarian cyst removal (January 2025)
History of travel:
No
Family history of such illness:
No
Severity of illness:
Severe (hospitalized and treated for sepsis)
Took Allopathic/Homeopathic/Ayurvedic medicine for illness:
Yes (Allopathic – IV antibiotics and supportive care) Dr. Yatharth Singh Suri
Took self-help and used home remedies: Doctor 's Name
No (direct hospitalization due to severity)
Avoid academic or physical exertion until medically cleared
This medical certificate is issued based on the clinical evaluation, medical history, and diagnostic evidence presented during the patient’s consultation. It is intended
solely for academic or professional documentation purposes and is valid only for the period of medical leave specified. The certificate must not be altered,
reproduced, or misused in any form without prior authorization from the issuing doctor or institution. The patient is advised to resume academic or physical
activities only after the recommended rest period and upon further medical assessment. Any attempt to tamper with or falsify the certificate will be considered a
breach of medical and ethical standards. For verification purposes, the concerned authorities may directly contact the issuing medical professional or institution. This
certificate does not serve as a legal or insurance document unless specifically supplemented with relevant paperwork. The confidentiality of the patient’s medical
condition is to be respected in accordance with applicable privacy laws and medical ethics.
DR. YATHARTH SINGH SURI
M.B.B.S., GENERAL MEDICINE | REGD. NO. MP-35499
dryatharth@medicalcertificate.in | 08068507810
PRESCRIPTION
NAME: Ms. Adaa Sayed AGE/GENDER: 19 years/Female
ISSUE DATE: 27/02/2025 DOCUMENT NO.: MC27022025ME0144998
Any emergency medicine/treatment taken:
Yes – Hospitalization, IV antibiotics, fluids, and critical monitoring
Any cast/bandage/cream applied:
Not applicable
Advice by the registered medical practitioner:
Complete bed rest until recovery
Avoid exposure to infection and strenuous activity
Follow-up and bloodwork required
Maintain hygiene, hydration, and adequate nutrition
Dr. Yatharth Singh Suri
Doctor 's Name
This medical certificate is issued based on the clinical evaluation, medical history, and diagnostic evidence presented during the patient’s consultation. It is intended
solely for academic or professional documentation purposes and is valid only for the period of medical leave specified. The certificate must not be altered,
reproduced, or misused in any form without prior authorization from the issuing doctor or institution. The patient is advised to resume academic or physical
activities only after the recommended rest period and upon further medical assessment. Any attempt to tamper with or falsify the certificate will be considered a
breach of medical and ethical standards. For verification purposes, the concerned authorities may directly contact the issuing medical professional or institution. This
certificate does not serve as a legal or insurance document unless specifically supplemented with relevant paperwork. The confidentiality of the patient’s medical
condition is to be respected in accordance with applicable privacy laws and medical ethics.
DR. YATHARTH SINGH SURI
M.B.B.S., GENERAL MEDICINE | REGD. NO. MP-35499
dryatharth@medicalcertificate.in | 08068507810
PRESCRIPTION
NAME: Ms. Adaa Sayed AGE/GENDER: 19 years/Female
ISSUE DATE: 27/02/2025 DOCUMENT NO.: MC27022025ME0144998
pecial notes by the registered medical practitioner:
Strict rest advised
Maintain hydration and nutrition
Avoid crowded/public places to reduce risk of reinfection
Regular monitoring and follow-up blood tests essential
Full Diagnosis of the illness:
Post-Sepsis Recovery (Bacterial Infection & Hospitalization
on 27-Feb-2025)
Suggested rest for 1 month from until cleared:
27-Feb-2025
Rx:
Tab Taxim-O 200 – 1 tab / BD (antibiotic)
Tab Dolo 650 – 1 tab / TDS (for fever and body pain)
Tab Rantac 150 – 1 tab / BD (before food, for gastric
protection)
Tab Electral / ORS – As required for hydration
Multivitamin supplement – 1 tab / OD
Tab Zincovit – 1 tab / OD
Dr. Yatharth Singh Suri
Doctor 's Name
This medical certificate is issued based on the clinical evaluation, medical history, and diagnostic evidence presented during the patient’s consultation. It is intended
solely for academic or professional documentation purposes and is valid only for the period of medical leave specified. The certificate must not be altered,
reproduced, or misused in any form without prior authorization from the issuing doctor or institution. The patient is advised to resume academic or physical
activities only after the recommended rest period and upon further medical assessment. Any attempt to tamper with or falsify the certificate will be considered a
breach of medical and ethical standards. For verification purposes, the concerned authorities may directly contact the issuing medical professional or institution. This
certificate does not serve as a legal or insurance document unless specifically supplemented with relevant paperwork. The confidentiality of the patient’s medical
condition is to be respected in accordance with applicable privacy laws and medical ethics.
