Certificate Type

Medical Certificate (Leave) Overseas Medical Certificate

Title

Patient Name *

Age

Gender

OP Number *

Place / Branch of Clinic *

Date of Examination

Date of Issue *

Diagnosis / Reason for Leave *

Leave From *

Leave To *

Total Days

Medicines Sufficient For (months) *

Destination Country (optional)

Medicines

Medicine Name	Package	Qty	Rate (₹)	Total (₹)

Grand Total: ₹ 0.00

Patient / Candidate Signature Capture patient's signature digitally now (otherwise a blank line is left for signing on paper)

Newlife Homoeopathy Clinic

Redefining The Health Care Culture · Since 1976

Dr. P. Nidheesh, MD(Hom) | Reg. No: 9281 A

MEDICAL CERTIFICATE

OP No: —

Place: —

Date of Issue: —

This is to certify that …

#	Medicine Name	Package	Qty	Rate (₹)	Total (₹)
Grand Total					0.00

This certificate is issued on the sincere request of the patient for genuine purposes.

Letterhead Details

Doctor Name Registration Number Clinic Name Tagline Default Place / Branch

Logo, Signature & Seal

Upload once — these are stored in this browser and reused on every certificate.

Clinic Logo

Doctor's Signature

Clinic Seal / Stamp

Google Drive Backup

Every certificate can be saved automatically to a folder in your Google Drive. This requires a one-time Google Cloud OAuth Client ID — see README.md in this project for the step-by-step setup. It only works when this page is served over http:// or https:// (not when opened directly as a local file), because Google does not allow sign-in from a file:// page.

Google OAuth Client ID Drive Folder Name

Not connected

Date Saved	Patient	Type	OP No.	Actions
No certificates saved yet.

Newlife Homoeopathy Clinic

MEDICAL CERTIFICATE

Letterhead Details

Logo, Signature & Seal

Google Drive Backup

Saved Certificates