MEDICAL CERTIFICATE FOR HIKING - Pinoy …

← Back to document page

MEDICAL CERTIFICATE FOR HIKING To whom it may concern: This is to cer?fy that the pa?ent has been examined by the undersigned on ________________ (MM/DD/YY) Based on the details regarding the climb, the personal informa?on provided by the pa?ent and the physical examina?on, I confirm that the pa?ent is: Fit to par?cipate in the climb Not fit to par?cipate in the climb Recommenda?ons: ________________________________________ ________________________________________ ________________________________________ ________________________________________ ________________________________________ _______ AQached are the details of the history and physical examina?on. Signature over printed name of physician: __________________ License number: __________________ PREPARED BY PITO MAGNO, MD AND GIDEON LASCO, MD, MSC. MUST BE FILLED OUT ONLY BY A LICENSED PHYSICIAN.

MEDICAL CERTIFICATE FOR HIKING To whom it may concern: This is to cer?fy that the pa?ent has been examined by the undersigned on _____ (MM/DD/YY)

  Medical, Certificate, Hiking, Medical certificate for hiking