Sample Doctors Excuses Sample
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Medical Center Name
Street Adress
City, State Zip
Phone, Fax
Date:
To Whom it may Concern:
The absence of the name who is physician advised due to illness.
This note certifies that someone was seen by this office for this medical issue.
Please excuse the name who is physician from month/day/year to month/day/year, the day they may return with the following limitation: light duty
Signature M.D.



