__________ (Doctor’s Name),
__________ (Clinic/ Hospital Address),
__________ (Recipient Details)

Date: __/__/____ (Date)

__________ (Sender’s Details)

Subject: Requesting illness confirmation letter

Dear Sir/ Madam,

My name is _______ (Name) and I am writing this letter in reference to the patient ID ____________ (patient ID).

I would inform you that on __/__/____ (date) I got admitted to your __________ (hospital/clinic) for treatment of _______ (illness name) illness for which I had to take leave from my office for ________ (number of days) days from __/__/____ (date) till __/__/____ (date). As per the company’s policy, I have to provide them with a confirmation from a side informing that I was ill and admitted to your reputed ______ (Hospital/clinic)

Therefore, I request you to kindly issue a medical certificate in my name stating my ________ (name/ gender/ illness/ patient ID/ any other relevant information). So that I will be able to avail of medical leave.

Thanking you,
__________ (Signature)
__________ (Name)
__________ (Contact Details)

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