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Medical certificate for school leave. Student, class, parent and days absent.
Free medical certificate for school leave: student, class, school, parent, days absent, identification mark, registration number. Print or save as PDF.
Certificate
Student
School and parent
Illness and absence
Clinic
Logo
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Doctor
Layout
Add the doctor's name and registration number to print.
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Clinic name
Dr. Name
Medical certificate for school leave
Sl. No. Date
Identification marks of the student
1.
2.
I, , after careful examination of the case, certify hereby that , , a student of at , child / ward of , of , whose signature or thumb impression is given above, is suffering from and I consider that absence from school for with effect from to is necessary for the restoration of his / her health.
Nature and probable duration of the illness:
Parent / guardian present: Signature
Place
Date
Based on the form in Appendix 2 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002. Register of Medical Certificates entry no.
Preview at reduced size. Prints at full A4.
What the rules ask for on a school leave certificate
The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 govern every certificate you sign. CBSE adds its own document list for Class X and XII attendance.
- 2002 Regulations, clause 1.3.3 and Appendix 2
A school leave certificate is still an Appendix 2 certificate
Clause 1.3.3 says the medical certificate shall be prepared as in Appendix 2, the form recommended for leave or extension of leave and for fitness. The regulations have no separate form for students, so this tool keeps the Appendix 2 sentence and adds the class, school and parent.
- 2002 Regulations, clause 1.3.3
Signature or thumb mark, address and an identification mark
The practitioner shall not omit to record the signature and/or thumb mark, address and at least one identification mark of the patient. For a child, a thumb impression taken in your presence meets the first part. The tool will not print until one identification mark is filled in.
- 2002 Regulations, clause 1.3.3
Register entry and a copy
A registered medical practitioner shall maintain a Register of Medical Certificates giving full details of certificates issued and keep a copy of each. A certificate for a schoolchild goes in the same register as any other; the serial number on the form is the entry.
- 2002 Regulations, clause 1.4.1 and Appendix 2, note
Registration number and the nature of the illness
Clause 1.4.1 requires the registration number on all certificates. The note under Appendix 2 asks for the nature and probable duration of the illness, with a brief résumé of the case attached.
- CBSE circular CBSE/COORD/Shortage-Attend./2025, 04.08.2025, and its SOP
CBSE Class X and XII: a government doctor for condonation
CBSE requires 75% attendance under Rules 13 and 14 of its Examination Bye-Laws. When a school forwards a shortage case on grounds of prolonged illness, the mandatory documents include medical certificates for the period of absence from a government doctor and all medical reports.
- 2002 Regulations, clause 7.7
An untrue certificate can cost the registration
A practitioner shown to have signed a certificate that is untrue, misleading or improper is liable to have their name deleted from the Register. A certificate for a child's absence is no exception, however small the request.
What a complete school leave certificate carries
Clause 1.3.3 and Appendix 2, with the details a school office needs to match the certificate to its attendance register.
Serial number from your Register of Medical Certificates, and the date and place of issue
Student's full name, age and sex
Class and section, and the name of the school
Parent or guardian's name, with a line for their signature
Residential address
Student's signature or thumb impression, taken in your presence
At least one identification mark
What the student is suffering from, worded with the parent's agreement
Number of days of absence, with the start and end dates
Nature and probable duration of the illness
Date from which the student may resume school, if known when you sign
Your name, qualifications, registration number and council, and your signature
A copy filed and the register entry made
The child's visits, already on file
Vitels keeps every patient's visits and prescriptions in one record and prints prescriptions on your letterhead with the registration number, so the history is there when a parent asks for a certificate. Vitels itself does not print certificates; this free tool does.
Straight answers
Can a private doctor give a medical certificate for school leave?
Yes. Any registered medical practitioner can certify a child's illness under the 2002 regulations, and nothing in them limits it to government doctors. The school decides what it accepts. For CBSE Class X and XII, the 2025 circular asks for a government doctor's certificate when a shortage of attendance is to be condoned for prolonged illness.
What should a medical certificate for school leave contain?
The Appendix 2 contents: the student's name, address, signature or thumb impression, at least one identification mark, the illness, and the period of absence with dates. Add the class, school and parent's name so the office can match it. Clause 1.4.1 requires your registration number, and the Appendix 2 note asks for the nature and probable duration of the illness.
Who signs the certificate, the child or the parent?
Clause 1.3.3 asks for the patient's signature and/or thumb mark, so the student signs or gives a thumb impression in front of you. The regulations say nothing about a parent signing. Schools usually want to know which parent brought the child, so this form prints the parent's name with a signature line.
Can I give a certificate after the child is back in school?
A certificate states the date it is issued and the period it covers. If you did not see the child during part of that period, certify only what you examined and can stand behind; clause 7.7 covers untrue or misleading certificates. CBSE's 2025 circular tells students to submit medical documents immediately after the leave, which avoids the question.
Is there an official CBSE format for a medical certificate?
The 2025 CBSE circular and its SOP list the documents a school must forward and give a proforma for the school's recommendation, but they do not prescribe a format for the doctor's certificate. State boards have their own rules; check the board's circular or ask the school before the parent comes back.
Does the tool store the child's details?
Patient details are kept only for this browser session, unencrypted, on this device; closing the tab or pressing Clear removes them. The letterhead stays for next time. Nothing is sent to Vitels, so as the treating practitioner you are responsible for what is typed here. Press Clear after printing on a shared computer.
This tool only lays out a form. It does not check who is using it or whether the contents are true. Only a registered medical practitioner who has examined the student may sign the printed certificate, and the practitioner alone is responsible for what it states (clause 7.7). This page summarises the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 as amended and the CBSE circular of 04.08.2025; it is general information, not legal advice. Schools and state boards may ask for more. Sources: nmc.org.in and cbse.gov.in, accessed 26 Oct 2026.
Related tools and pages
Medical certificate rules for doctors
Clause 1.3.3, the register, sick leave and fitness, and the penalty for a false certificate.
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The adult sick leave form from Appendix 2, with the period of absence.
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Fit to join duty after illness, on the same letterhead.
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