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Medical Excuse Note Template

This document is a medical excuse note from Dr. Kim for Nyeesha Wiltshire. It requests an excuse from work, school, or other activities due to an injury or illness for the dates of March 12, 2024, to March 13, 2024. The note includes space for additional comments from the doctor.

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eesha18.nw
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145 views1 page

Medical Excuse Note Template

This document is a medical excuse note from Dr. Kim for Nyeesha Wiltshire. It requests an excuse from work, school, or other activities due to an injury or illness for the dates of March 12, 2024, to March 13, 2024. The note includes space for additional comments from the doctor.

Uploaded by

eesha18.nw
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

MEDICAL EXCUSE NOTE

Doctor’s Name: Dr. Kim


Address: 1645 North Main st

Date: 03/12/2024

To Whom It May Concern:

Please Excuse: ________________________________________________


Nyeesha Wiltshire

From:
⃞ Work
⃞ School
⃞ Other: __________________________________________________

Due To:
⃞ Injury
⃞ Illness
⃞ Others: _________________________________________________

For the following dates: ______________


03/12/2024 to ______________
03/13/2024

Doctor’s Comments:

__________________________
Dr. Kim

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