Neftaly Medical Certificate
Patient Name: ____________________________
Date of Birth: ____________________________
Gender: _________________________________
Date of Examination: ______________________
Certificate Issued On: ______________________
Medical Diagnosis:
Hypoglycemia (Low Blood Glucose Level)
ICD-10 Code: E16.2 – Hypoglycemia, unspecified
Clinical Findings:
The patient presented with symptoms consistent with hypoglycemia, including:
- Shakiness and sweating
- Dizziness or light-headedness
- Palpitations
- Confusion or difficulty concentrating
- Irritability or sudden behavioral changes
- Recorded blood glucose level: ___________ mmol/L (below normal range)
Treatment Provided:
- Immediate administration of fast-acting glucose
- Monitoring of blood glucose levels
- Dietary and lifestyle counseling
- Review and adjustment of medications (if applicable)
- Advised on strategies to prevent recurrence
Prognosis:
The patient responded well to treatment and was stabilized. Rest and monitoring are advised for the next 24–72 hours, depending on symptom severity and underlying cause. Further investigation or follow-up may be required.
Medical Certificate Statement:
This is to certify that the above-named patient was diagnosed and treated for Hypoglycemia at Neftaly Medical Center. As a result, the patient is temporarily unfit for work/school from:
_________________ to _________________
The patient may return to normal duties on: _________________, subject to clinical improvement and follow-up review.
Attending Physician: _________________________
Medical License Number: _____________________
Signature & Official Stamp: ___________________