Neftaly Medical Certificate

Patient Name: ____________________________
Date of Birth: ____________________________
Gender: _________________________________

Date of Examination: _____________________
Certificate Issued On: _____________________

---

Medical Diagnosis:

Hypotension (Low Blood Pressure)
ICD-10 Code: I95.9 – Hypotension, unspecified

---

Clinical Findings:

The patient presented with the following symptoms consistent with hypotension:

• Dizziness or light-headedness
• Fatigue
• Blurred vision
• Fainting (in some cases)
• Low blood pressure reading: ________ mmHg

---

Management & Treatment Provided:

• Initial rest and monitoring of vital signs
• Oral rehydration and dietary advice
• Adjustment of medications (if applicable)
• Advised increased fluid and salt intake
• Referral for further cardiovascular assessment (if needed)

---

Prognosis:

The patient has been advised to rest, avoid sudden changes in posture, and follow dietary and fluid recommendations. Recovery is expected with appropriate care and monitoring.

---

Medical Certificate Statement:

This is to certify that the above-named patient was diagnosed and treated for Hypotension at Neftaly Medical Center. Due to this condition, the patient is medically unfit for work/school from:
_________________ to _________________
The patient may resume normal activities on: _________________, subject to improvement and further evaluation.

---

Physician’s Name: _________________________
Medical License Number: ___________________
Signature & Official Stamp: ________________