Tappan's certificate
05/09/2016
me Mr. Tappan, NJ / Tappan Jersey woman. ........................................
Licensed medical professional at ... ........................
the medical profession Or place of work, Or address ............................................... .................................................. .................................................. ............................
be examined Mr. / Mrs. / Ms ............................................. .....................................
identification number.
the place can be reached. .................................................. .....
then On .......... ........... months. Fri. .............. Certifies that
Mr. / Mrs. / Ms .......................................... ......... is not following
(1) TB in metastatic disease
(2), lymphatic filariasis in the symptoms that are offensive to the society
(3) the disease of addiction is to blame
(. 4) alcoholism
(5), contagious disease or chronic symptoms or apparent violence and hinder the performance of its duties under the CSC.
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