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Health Certificate  Form

Health Certificate Form

Use a health certificate for humans 0 template to make your document workflow more streamlined.

History List any significant past medical surgical or psychiatric conditions 3. Present illness If there is any ongoing care/treatment provide detail on Medical Information Certificate 4. Allergy List any allergies to food or medications Is there any possibility of anaphylaxy 5. Recommendations regarding travel/study abroad Print name of Care Care Provider Official Stamp Name of Institution or Clinic Health Care Provider Signature Date /min Part 2-1 Tuberculosis TB Screening Questionnaire to be...
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