Medical Certificate Request Letter Format


Sample application letter for issuance of medical certificate from a doctor, institute, medical center, hospital, etc.

Application for Medical Certificate from Hospital

Dear Dr. Sehrish Asghar,

I am Sameena, your patient of eyesight for 4 months. As you suggested rest of two weeks whenever I start the medicine. Please note I am a working lady and doing the job as an administrator in a multinational company. For leave of one week, my company requires a doctor’s recommendation letter or certificate for having rest. I request you to please issue me a medical certificate/letter which can help me to get a leave of one week from the company.

Warm Regards,


Request for Medical Certificate from Institute

The Chairman,
AHF Foundation
XX Sector, D.H.A, Lahore

Subject: Issuance of letter to spend some quality time with my Child

Dear Sir,
It is stated that I am a Government employee, working in the CNW department Kohat. My daughter, Rosey Shakir is an autistic patient, studying in your prestigious institute. I have shifted my family to Lahore only for her treatment, and schooling from Kohat. I use to travel 700 km every week to visit my family.

During the last 3- months, I couldn’t spend time with my family as a result she has started behaving much aggressively, my department has rejected my application for leave from the office without realizing the situation I am passing through.

Therefore, it is requested that issue a certification/letter on behalf of your institution, in which it is mentioned that I have to pay some special attention and spend some more time with my child during these months until she becomes calm again.

Your favor will help me a lot in securing my job, and career, and it could become easier for me to pay some attention to my child, and family. I shall be very grateful to you.

Shakir Kamal

Request for the Issuance of Medical Certificate

The Medical Superintendent,
Care Hospital,
Glasgow, Scotland.

Dear Sir,

It is submitted that I am working as a computer operator in Vodafone Telecom. Sir, for the official purpose I need a medical fitness certificate as I have to apply for a training session in abroad. The receipt number of the medical report which I had obtained was 0000.

Further details with respect to my medical reports are written below.

Name: Peter Pounce
Father Name: William Smith
Age: 30 Years
Blood Sample Number: 0000

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