Tag Archives: Medical Certificate

Request Application for Issuance Medical certificate

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

To,

The Medical Specialist,

Doctor’s Hospital.

Dear Sir,

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. 

Kind Regards,

Ian

222, B- Baker Street, Lahore

Sample Medical Certificate Issuance Request

Doctor’s Hospital

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.

Kind Regards,

Gabriel

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Authorization Letter for Release of Medical Records

Authorization Letter for Release of Medical Records. Sample Authorization Letter for Medical Care. The given formats of authorization letter to collect medical reports can be used by people who want to give authorization or responsibility to any other person.

Authorization Letter for Release of Medical Records

To,
Mr. John Smith,
Northway Colony.
8. Dec.2015.

Subject: Authorization letter to receive medical reports/records on my behalf.

Dear Sir,

I, Jane jade, writing this letter to indicate that I authorities the Mr. Kate to receive my medical reports on my behalf from your testing laboratory. My medical record number is ser 321 and I am your valued customer from last seven years. Your services were always superb and you maintained extra ordinary privacy and confidentiality. I am diabetic, examine and maintain my blood sugar tests always through your laboratory. Due to some personal reasons, I am out of town and it would take time to come back to my town. I need my results of blood test reports because I have to consult a doctor here for my advance treatment. So I, Mr. Jane Jade, hereby authorize the Mr. Kate, to receive my medical reports on my behalf from your laboratory.
Kindly did not hand over my other any medical report to anyone else. Make sure you will properly investigate the Mr. Kate through his original ID cards and authorize letter with my valid signatures. This authorization is valid for only this month of December. Enclose with this letter all information of Mr. Kate are attached. Please contact me if you need any other information. My contact number is 090998876. This is my personal number and I am available here for 24/7 hours.
I appreciate both you and Mr. Kate’s assistance in this matter. Please accept my vehement protestation of gratitude in this matter. Hopefully a trust established among us will continue ever after like this, and I think it’s a mutual trust, even more than mutual confidentiality, that holds us associations together.

Thank you.

Sincerely,

Mr. Jane Jade
Green villas Joseph road street 10
09887123
Date 5th December

Sample Authorization Letter to Receive Medical Reports

To,
Agfa khan testing laboratory.
Main Franchise.
Street 23, Canada

Subject: Letter to testing laboratory to authorize other person to receive  medical reports /records/certificate on his behalf

Dear Sir,

It is stated that I am patient of diabetes and regularly maintain my blood test record through your center. Recently I have my blood sample for my keen investigation about my health. Unfortunately in these days I am out of station and cannot come to your center to collect my medical reports. I am sending my brother to your franchise to collect my medical reports as I cannot come but I can’t wait more for results of my reports. My registered patient number is SRE56.
I am giving the authority to my brother Mr. kales to collect my medical reports on my behalf. You are requested to allow him to collect medical reports on my behalf. Feel free to contact me at 11123345666.Thank you very much.

Respectfully Yours,
Carl Rogers

Sample Application for Medical Leave

Sample Application for Medical Leave

To
The Vice Principle
The Radiant Way School
SMT Campus, Lahore

Subject: Medical Leave by student

Honorable Sir,

With utmost respect, it is stated that I am suffering from severe asthmatic attack since last night. Dr has suggested me to get nebulizer after each 4 hours for consecutive 3 days. It is very difficult for me to come to school in this condition. I have bad throat and chest congestion as well. I need proper rest to recover because of this poor condition. I cannot come to school with this health. I need a leave till I get recovered completely.
Kindly grant me a medical leave for three days. I shall utterly be obliged. I am attaching my medical papers and doctors’ prescription with this application. Thanks for your consideration as I get well I will come back to school.

Yours Obediently,

Ahmad Shah
Class 9 th
Section Science Subject
Roll no 17
Date of leave: 2.03.17 to 4.02,17

Medical Leave Application by Parents

To
The Principle
Garison School
Boys Campus

Subject: Medical Leave by Parents

Respected Madam,

With best regards, it would like to inform you that my son Raza Ahmad is studying in your institute. He is very intelligent and hard working student. Yesterday when he came back from school to home suddenly he falls down from stairs during playing with some guest. He is seriously injured. He has got four stitches on his head. Doctor had prescribed him complete bed rest for at least 15 days. In this critical condition he cannot be able to come to school and join his classes.
Kindly grant him a leave for 15 days. I am sending you all real documents and discharge slip of hospital with this application. I shall be highly beholden.Thanks.

Yours Sincerely,

Mahmad Ali
Senior Vice President
Tanning Works and Machinery
Date 7.09.2018

Authorization Letter to Collect Medical Report

Authorization Letter to Collect Medical Report. Medical authorization letter. Sample Authorization Letter for Medical Care. The given formats of authorization letter to collect medical reports can be used by people who want to give authorization or responsibility to any other person. Following formats can be used if any person wants to make someone responsible of collecting medical reports.

Authorization Letter to Collect Medical Report

The Director General,
Elma Pharma Lab.

Subject: Authorization Letter to Collect Medical Reports

Respected Sir,

With due reverence it is stated that, this letter is issued to Mr. ABC who is our new acting Analysis Department Manager on account of his authorization to collect and see all the medical reports we will be having on board. Our ex-manager is on study leave for a span of about 2 years and till than we have made Mr. ABC the acting manager. We hope that you will collaborate with him and assist him in all ways. Thanks and Regards,

Sharma Singh

Contact: 000444444

Sample Authority Letter to Collect Medical Reports

George Stephen
Customer Relation Manager,
ABC Hospital.

Subject: Authorization Letter to Collect Medical Reports

Respected Sir,

This letter serves as an official authorization letter to collect the medical reports of Mr. James Kin, who will be having long term medical treatment at your hospital. As per the requirements of your
organization, authorization is given to Mr. DEF and Mr. GHI. Both of them will be collecting the reports on alternative days. Kindly forward them the schedule and their contact details are attached with the letter. Thanking You.

Regards,

Rija Sharma

Contact: 000000000000000

Authority Letter to Collect Medical Certificate

Mrs. Gill
Manager, ABC Pharma.

Subject: Authorization Letter to Collect Medical Reports

Respected Ma’am,

This letter is issued as per request of Mr. ABC in order to authorize him to collect annual medical reports of our employees. In case any other person will be made responsible, we shall provide you confirmation first. Thank you for cooperation.

Regards,
Name: ————
Contact: ——————-