Emergency Admission Certificate

You might also like

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 1

EMERGENCY ADMISSION CERTIFICATE

THIS IS TO VERIFY THAT MR/MRS/MS _________________________________________

S/O.D/O.W/O. _______________________________________ AGED ABOUT _________

ADMITTED IN OUR HOSPITAL IN _________________________________ DEPARTMENT

UNDER EMERGENCY ON __________________________ AT ____________ AM/PM

SIGNATURE AND DESIGNATION OF THE

ATTENDING MEDICAL AUTHORITY

You might also like