SURAT KETERANGAN ISTIRAHAT
MEDICAL CERTIFICATE
Nama
/Name
/Name
No. Pegawai
/Badge
/Badge
Perusahaan
/Company
/Company
Berdasarkan pemeriksaan medis yang dilakukan, bersangkutan menderita sakit, membutuhkan istirahat sakit selama :
Based on the medical examination carried out,
the person concerned suffers from illness,
requires sick rest for:
Durasi
/Duration
/Duration
:
Tanggal Mulai
/Start Date
/Start Date
:
Tanggal Selesai
/End Date
/End Date
:
Klinik
/Healthcare Facility
/Healthcare Facility
:
Dokter
/Doctor
/Doctor
Tanggal dibuat
/Created date
/Created date
: