Medical Certificate Sample PDF – Filled Examples Explained Field by Field

Annotated, filled sample medical certificates explained field-by-field. Learn what information goes where and how to read an official medical certificate.

✔ Reviewed by Dr. Sarah Mitchell, MBBS · Updated April 2026

Reading a Filled Medical Certificate

Understanding how a completed medical certificate looks helps you verify that the certificate you receive from your doctor is complete and will be accepted by your employer or institution.

Sample: Fully Filled Sick Leave Certificate

Sample Certificate – All Fields Filled (Fictional)

SUNRISE MEDICAL CENTRE Reg. No: H-MH-2019-02847 | Tel: +91-20-4521-8899 Plot 12, Aundh Road, Pune – 411007 MEDICAL CERTIFICATE To Whomsoever It May Concern, This is to certify that Mr. VIKRAM DESAI, Age: 28 Years, Gender: Male, residing at 45 Karve Road, Pune, attended this medical centre on 07/04/2026 and was examined by me. The patient has been diagnosed with ACUTE GASTROENTERITIS (Stomach Infection) with associated Dehydration. He is advised complete bed rest and is UNFIT FOR DUTY from 07/04/2026 to 10/04/2026 (4 days, inclusive). The patient may resume duties from 11/04/2026, subject to clinical improvement. This certificate is issued on the request of the patient for official use only. Pune, 07/04/2026 Dr. MEENA IYER, MBBS MD Reg. No. MCI-2010-MH-39172 [SUNRISE MEDICAL CENTRE STAMP]

Field-by-Field Explanation

FieldIn SampleWhy Important
Hospital Reg. NoH-MH-2019-02847Allows employer to verify hospital is registered
Patient full nameVIKRAM DESAIMust match ID documents exactly
Visit date07/04/2026Proves examination occurred
DiagnosisAcute GastroenteritisMedical basis for leave
Leave period07/04 to 10/04 (4 days)Exact dates for HR records
Doctor Reg. NoMCI-2010-MH-39172Verify at nmc.org.in

How to Download Your Certificate as PDF

When you use our Certificate Generator, you can:

  1. Fill in all your details in the generator form
  2. Click "Generate Certificate" to see the live preview
  3. Click "Download PDF" to save as a PDF file
  4. Or use "Print" and choose "Save as PDF" for maximum compatibility

Remember: our generated certificates are for reference and educational purposes only — they are not official documents.

Generate Your Own: Try our Free Certificate Generator to see how a filled certificate looks with your own details.

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