Neftaly Medical Certificate
Patient Name: ____________________________
Date of Birth: ____________________________
Gender: _________________________________
Date of Examination: ______________________
Certificate Issued On: ______________________
Medical Diagnosis:
Genital Herpes (Herpes Simplex Virus Infection)
ICD-10 Code: A60.9 – Anogenital herpesviral infection, unspecified
Clinical Summary:
The patient was examined and diagnosed with genital herpes, a viral infection caused by the Herpes Simplex Virus (HSV), confirmed through:
- Clinical examination
- Laboratory testing (e.g., viral culture, PCR, or serologic testing)
Symptoms observed include:
- Painful genital sores or blisters
- Itching or burning sensation
- Flu-like symptoms (in some cases)
- Swollen lymph nodes
This condition may present as a primary infection or recurrent episode.
Treatment and Management:
- Antiviral therapy prescribed (e.g., Acyclovir, Valacyclovir)
- Pain relief and supportive care provided
- Patient education on transmission, hygiene, and recurrence
- Advised temporary abstinence and use of protection to prevent spread
Prognosis:
Genital herpes is a manageable chronic condition. During an active outbreak, symptoms can interfere with daily activities, and time off is recommended for rest and recovery. The patient is temporarily medically unfit to attend work/school depending on severity and general condition.
Medical Certificate Statement:
This is to certify that the above-named patient has been diagnosed with Genital Herpes and is currently receiving treatment at Neftaly Medical Center.
The patient is advised to refrain from work/school duties from:
_________________ to _________________
A return to normal duties is expected on: _________________, subject to clinical improvement and follow-up care.
Attending Physician: _________________________
Medical License Number: _____________________
Signature & Official Stamp: ______________