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Karen A. Formoso, M.D.: Medical Certificate

This document contains contact information and a template for a medical certificate from Dr. Karen A. Formoso. It lists her address, phone numbers, office hours, and license number. The medical certificate template includes fields for the patient's name, age, sex, diagnosis, date seen, recommended treatment, and purpose of the certificate. It is signed by Dr. Formoso and indicates she is a medical consultant and clinic physician.

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Tiffany Yuhengco
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861 views1 page

Karen A. Formoso, M.D.: Medical Certificate

This document contains contact information and a template for a medical certificate from Dr. Karen A. Formoso. It lists her address, phone numbers, office hours, and license number. The medical certificate template includes fields for the patient's name, age, sex, diagnosis, date seen, recommended treatment, and purpose of the certificate. It is signed by Dr. Formoso and indicates she is a medical consultant and clinic physician.

Uploaded by

Tiffany Yuhengco
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
Download as pdf or txt
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KAREN A. FORMOSO, M.D.

PHYSICIAN
Lic. No. 0137952
183 Capas St. Cor. Nadurata St.
10th Ave., Grace Park Caloocan City Time : Mon - Sat : 1:00pm - 7:00pm
Cell No.: (0995) 8719077 (text only) Sunday : 8:00am - 12:00nn
Secretary Cell. No.: (0906) 3415881

MEDICAL CERTIFICATE
To whom it may concern:

This is to certify that Mr./Ms./Mrs. _________________________________

age/sex_____________ of _____________________ was seen and examine on

____________________ and was diagnosed to have ________________________

_________________________________________________.

I therefore recommend ___________________________________________

This certificate is being issued for _____________________________ purposes only.

Yours truly,

__________________________________

KAREN A. FORMOSO, M.D.

Medical Consultant/Clinic Physician

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