Below sample Request application Format for the issuance of Medical Certificate. You can use these sample issuance of a medical certificate from a doctor, institute, medical center, hospital etc. You can change these sample as per your requirement.
Request Application for issuance medical certificate
The Medical Specialist,
Subject: Request Application for issuance medical certificate
Dear Dr. Jennifer,
I am Ian, I was your patient of eyesight for a few weeks. You prescribed me medicine and told me to rest for 2 weeks at home whenever I start the medicine. I work at a multinational company called Winzip Insurance as an Administrator and I need a medical certificate so I can apply for a leave of 2 weeks. For leaves over a week, my company requires a medical certificate. Without the issuance of a medical certificate, my leave would not be approved. Please issue me a medical certificate stating that I need a rest of 2 weeks and during that time I won’t be able to come to the office.
222, B- Baker Street, Lahore
Sample Medical Certificate Issuance Request
Subject: Medical Certificate Issuance Request
Dear Dr. Emily,
I am Gabriel, 15 days ago I had an accident and I was put under your care. During that time, I had to miss University because for the initial 5 days I was admitted to the hospital and later on I was prescribed bed rest to let my injuries heal completely. Now that I’m fully fit, I’d like to resume going to my university. I was marked absent during the time I missed University and fined as well. In order to waive that fine, my university has asked me to get a medical certificate issued by the doctor I was getting treatment from. I request you to please issue me a medical certificate stating I met an accident and you prescribed me bed rest of 2 weeks so I can resume going to University and get the fine waived.