Stamp of the medical institution name and address is placed in the upper right corner. Optional name can be printed or handwritten.
In the upper right and lower right corners are stamped with a print for sick leave.
In some cases, have to bear the additional printing. In the first case - when the person does not have registration at the place of the disease (visitors, travelers, tourists in the area). In the second case, the examination of citizens, which was sent to medical examination. The seal shall be affixed to the signature of the Director confirming the conclusion.
The discrepancy between the print in the upper right corner and the bottom is allowed when redirecting the patient to another medical facility.All printing should be clear without washouts and drips.Some types of prints may be without the name of the institution. This psychiatric clinics, narcological, infectious, the centers of struggle against AIDS.
The leaf of disability must be completed without errors with a pen or printing station.
On the front side is indicated, issued by the hospital sheet is primary or a continuation of a previously issued, the number, month (in words) and year of issuance, surname, name, patronymic of patient, age (in years), gender, full name of the patient. Also indicated is issued sick leave at the main place of work, or work part-time.
In the relevant boxes specify the disease or other reason (maternity), mode of treatment, the level of abuse of the regime, what to and what number the mode was broken.
In the "off" stamped in Arabic numerals the date of issue or (if necessary) date of next renewal. The doctor puts a personal signature and seal.
If the decision is made by a medical Commission, the additional signature of the Chairman of the Commission.
In the line "get to work" date is written in words.
If the patient continues to hurt, then make the corresponding entry. In the old sheet write, which issued new, and put its number, date of issue and signature of the doctor.
If disability, sick leave close and make the appropriate entry.
If a medical certificate is lost, a duplicate shall be issued.