You will need
  • form reference form 095;
  • form reference form 027.
Instruction
1
Help shape 095 fills the doctor or therapist, depending on patient age. It is issued after the end of the disease at the time of discharge to study.
2
On each filled certificate shall bear a serial number. Then highlighted the desired value of the printed in the entry form. It shows the student what institution issued the certificate. Put legible date of issue, the abbreviated name of the educational institution, such as Altai state medical University, indicate the name of the patient and date of birth (day, month, year).
3
Next is written the diagnosis on the basis that he was exempt from training, for example, the flu. Emphasizes the presence or absence of contact with infectious patients.
4
In the respective graphs indicate date of illness, date of physician visit, date of extending help and end date of the disease. Stamped number, which you want to begin classes.
5
Put the stamp of the clinic, the full name of the attending physician, his signature and personal seal.
6
If the illness lasts more than 14 days, in addition to the application for the certificate of the certificate 095 027. It is, in fact, an extract from the medical record or history of the disease. It includes all the patient details, home address, date of birth, date of referral to inpatient treatment, discharge from hospital, the diagnosis and complete description of the disease. Help put the seal of a medical institution which has issued the document, the signature and stamp of doctor, doctor from the hospital, the signature and seal of the chief physician.
7
Help form 027 issued for 75 days. If the disease persists or progresses, gave serious complications, the issue of disability.
8
Disability sets medical-social expert Commission on the basis of all the submitted surveys, extracts from the history of the disease and General condition of the patient.