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MedicalCertificate Exmple

This medical certificate certifies that Jareena Meneses Samson, a 24-year-old female, consulted with Dr. Dayang Sitti Rohilmina B. Jalad due to cough, sore throat, and headache. The doctor's impressions were an upper respiratory tract infection and COVID-19 suspect. The doctor recommended ongoing quarantine since the patient had a known exposure to a COVID-19 positive patient and was still experiencing symptoms. Oral medications were given and the patient was advised to extend quarantine for 5-7 days and inform the local health authorities.

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Jareena Samson
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9K views1 page

MedicalCertificate Exmple

This medical certificate certifies that Jareena Meneses Samson, a 24-year-old female, consulted with Dr. Dayang Sitti Rohilmina B. Jalad due to cough, sore throat, and headache. The doctor's impressions were an upper respiratory tract infection and COVID-19 suspect. The doctor recommended ongoing quarantine since the patient had a known exposure to a COVID-19 positive patient and was still experiencing symptoms. Oral medications were given and the patient was advised to extend quarantine for 5-7 days and inform the local health authorities.

Uploaded by

Jareena Samson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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MEDICAL CERTIFICATE

Date: 2022-01-29
To whom it may concern:

This is to certify that JAREENA MENESES SAMSON


24 years old, F , residing at Roxas St. Bayambang, Pangasinan
— consulted with the undersigned, due to
Cough, Sore throat, Headache

Impressions:
T/C UPPER RESPIRATORY TRACT INFECTION;
COVID-19 SUSPECT
Recommendations:
-With known history of exposure to COVID-19 positive patient. Ongoing quarantine.
Consulted today still with above symptoms.
-Oral medications given.
-Advised to extend quarantine for 5-7days// inform BHERT.
-Strictly follow safety health protocols.

This certificate is being issued upon the request of the above-mentioned name
2022-01-29 for whatever purpose it may serve except medico legal.
this ___________
Disclaimer: Information provided in this certificate is clearly based on clinical history alone as
provided by the patient via teleconsult. He/she was not seen nor examined physically. Final discretion
is still based on the company’s doctor or safety officer.

DAYANG SITTI ROHILMINA B. JALAD, MD


General Practitioner
License no. 0150114

To verify this document, Scan the QR code above or send an email to contactus@ekonsultaclinic.ph

Consult via teleconsult. If symptoms persist, proceed to the nearest emergency room

IMPORTANT: Any kind of counterfeiting or imitating any handwriting, signature or rubric; making untruthful statements in a narration of facts; altering true dates; tampering, alteration, or intercalation of this
document; or issuing in an authenticated form a document purporting to be a copy of this document, or including in such a copy a statement contrary to, or different from this document is punishable by law.

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