MEDICAL CERTIFICATE

DATE: JANUARY 15, 2019

TO WHOM IT MAY CONCERN:

This is to certify that ___________________________________,________y/o, male/female and a resident of

____________________________________________came in for medical examination and the result revealed that he/she is :

Fit to work/training/immersion on ______

To travel

Undergo procedure

Require more test(s)

This certification is issued upon the request of the interested party for whatever purpose it may serve.

Issued this _____ day of ________________ at _______________________________.

_________________________ M.D.
Attending Physician
__________________________________________________________________________________________________

MEDICAL CERTIFICATE
DATE: JANUARY 15, 2019

TO WHOM IT MAY CONCERN:

This is to certify that ___________________________________,________y/o, male/female and a resident of

____________________________________________came in for medical examination and the result revealed that he/she is :

Fit to work/training/immersion on ______

To travel

Undergo procedure

Require more test(s)

This certification is issued upon the request of the interested party for whatever purpose it may serve.

Issued this _____ day of ________________ at _______________________________.

_________________________ M.D.
Attending Physician