Application for Issuance of Health Fitness Certificate

Sample of Application for Medical Certificate or Application to issue medical certificate. Application to issue medical/health certificate. In order to get medical certificate from hospital or private clinic as per the requirement of office employees, teachers and other working staff. This health certificate also can be used for abroad visa or employment purpose/foreign jobs etc.

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Application for Issuance of  Health Fitness Certificate

The Principal,
Deva Public School,
Shimla, India.

Subject: Issuance of Health Fitness Certificate for Teacher

Respected Sir,

Humbly stated that, I have got an offer of teaching from an institute. They are paying me more than that I am getting here. I had worked here for two years and now I have got a chance to move on. I had completed all my course of this session and now I want to resign from the job. My job is confirmed there as I accepted the offer.

The institute where I have to join asked me for a Medical Fitness Certificate which is mandatory in Visa policy and that should be issued from the school where I am teaching. So I request you to issue me the certificate so that I can provide it to the institute and all other matters should be resolved. I will be pleased if my desired certificate can be made as soon as possible. I will be very thankful to you.

Yours sincerely,
Mr. Omit Malik.

Application for Issuance of Medical Fitness Certificate Sample

The Manager,
Tien’s Private Limited,
Depaal Pur, India.

Subject: Issuance of Health Fitness Certificate for Employee

Respected Sir,

Please be informed that I am a member of this company from the last three years and I am working as a supervisor. I was given job on the base of my bachelor in medical studies. I was trying to go abroad to complete my masters from the last two years on the base of scholarship. Now I have got a Visa offer to study abroad to complete my masters. I want to avail this offer.

The only difficulty is that I don’t want to resign from my job. I request you to issue me a Medical Fitness Certificate. A period of one year is required to complete my studies. By completing my masters I will be able to provide better ideas for the betterment of the company. I will be very grateful to you.

Yours sincerely,
Mr. Silver John.

Application for Issuance of Medical Fitness Certificate
Application for Issuance of Medical Fitness Certificate


Sample Medical Certificate required for USA Visa.The trend of emigration is catching speed and individuals are dying to go USA/UK especially and for that reason the certificate is required by Visa department. Such applications are for Visa applicant.

Sample Medical Certificate Required for USA Visa


Mr. Mohan Bhatnagar,
House No. 5, Street No. 10 Phase A
Shimla Society, India.

Subject: Issuance of Medical Fitness Certificate from Hospital

Respected Sir,

We had received your test details from the respective departments yesterday and found you fit from each side. Your Urine report was good and so was BP test, sugar test and hepatitis test. Your hemoglobin test showed 1% down statement but it can be achieved with in a week as required dose and food items are listed in the medical prescription attached with this report. Thank you for trusting us.


Mr. Omit Malik
Head of Departments

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