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Certificate Template
Medical Certificate Sample
Sample medical certificate
Sample medical certificate
1
MEDICAL CERTIFICATE
I, the undersigned Dr___________
__________________
_, Doctor of Medicine,
Certify that
the examination
of Mr/Ms____________
___________________
___
Date of bi
rth: _____
_________________
Age: _________
_________
reveals no
contraindications for participating in
a
cycling
competition
.
Medical
certi
ficat
e issu
ed in
(place
):
Date: _____
_______________ Do
ctors sig
n: ____________
_________
Doctor Sta
mp
:
Download
Sample medical certificate
DOC: 46.4 KB | PDF: 37.1 KB (1 page)
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