FORM - 4 (See Rule-19) Medical Certificate for Non-Gazetted Officer recommended leave or Extension of leave or commutation of leave. Signature of Government Servant ............ after careful personal examination of the case hereby certify that Shri / Smti / Kumari...................... whose signature is given above is suffering from...............and I consider that a period of absence from duty of ................. days with effect from.............is absolutely necessary for the restoration of his / her health. Date........... Authorised Medical Attendant
