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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3 thoughts on “Medical Certificate Request Letter Format”

    1. Dear Sir,
      I want to request my medical certificate to get admission to the college. It is compulsory to submit the admission form. So please issue my certificate urgently as the last application date is approaching. I will be grateful to you.
      Sincerely Yours,
      Your Name

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