Republic of the Philippines
Province of Samar
MUNICIPAL HEALTH UNIT
Marabut, Samar
MEDICAL CERTIFICATE
___________________
(Date)
To Whom It May Concern:
THIS IS TO CERTIFY that __________________________ of ______________________________
(Name of Patient) (Address)
Was examined and treated at the Municipal Health Office on ______________________________, 20
______ with the following diagnosis:
(Date)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
And would need medical attention for _______________________________________ days barring
complication.
(Attending Physician)
__________________________
(Attending Physician)