Free tool
Unfit certificate format. Unfit to attend duty, with the dates spelt out.
Free unfit certificate maker: unfit to attend duty, work or classes, start and end dates, identification marks, registration number. Print or save as PDF.
Certificate
Patient
Illness and unfit period
Clinic
Logo
Clinic logo only; a photograph of yourself on a letterhead is barred by clause 6.1.2. PNG or JPG, stays in this browser.
Doctor
Layout
Add the doctor's name and registration number to print.
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Clinic name
Dr. Name
Medical certificate of unfitness
Sl. No. Date
Identification marks of the patient
1.
2.
I, , after careful examination of the case, certify hereby that , , of , whose signature is given above, is suffering from . He / she is unfit to attend duty for , from to (both days inclusive), and I consider this period of absence absolutely necessary for the restoration of his / her health.
Nature and probable duration of the illness:
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 an unfit certificate
The 2002 regulations set the form and contents for every leave certificate. For central government staff the CCS (Leave) Rules, 1972 add Form 4 and who may sign it.
- 2002 Regulations, clause 1.3.3 and Appendix 2
“Unfit” is the absence-from-duty sentence
Appendix 2 does not use the word unfit. Its leave paragraph certifies that a period of absence from duty, with effect from a date, is absolutely necessary for the restoration of health. This tool states the unfit period in plain words, prints the end date, and keeps that sentence.
- 2002 Regulations, clause 1.3.3
Identification marks are not optional
When issuing a medical certificate the practitioner shall always enter the identification marks of the patient, and shall not omit the signature and/or thumb mark, address and at least one identification mark. The tool will not print until one mark is filled in.
- 2002 Regulations, Appendix 2, note; CCS (Leave) Rules, Form 4, Note 1
Nature and probable duration
The Appendix 2 note says the nature and probable duration of the illness should also be specified, with a brief résumé of the case attached. Note 1 to Form 4 of the CCS (Leave) Rules says the same for central government staff.
- CCS (Leave) Rules, 1972, rule 19(1)(ii) and Form 4, Note 2
Central government staff: Form 4, signed after the employee signs
A non-gazetted central employee applies with a certificate in Form 4. A registered medical practitioner may give it when a CGHS beneficiary is away from the CGHS area or headquarters and no Authorised Medical Attendant is available within eight kilometres, or one is hard to reach. Form 4 is filled after the employee's signature is taken and may not certify a change of locality.
- CCS (Leave) Rules, 1972, rule 19(3) and 19(5)
The office decides the leave
The grant of a medical certificate does not in itself confer any right to leave; it goes to the authority competent to grant leave. That authority may ask for a second opinion from a medical officer not below the rank of Civil Surgeon or Staff Surgeon.
- 2002 Regulations, clause 7.7
An untrue certificate can cost the registration
A practitioner shown to have signed a certificate, given for administrative purposes or courts, that is untrue, misleading or improper is liable to have their name deleted from the Register.
What a complete unfit certificate carries
Appendix 2 and clause 1.3.3, with the period written so an office can count the leave without asking.
Serial number from your Register of Medical Certificates, and the date and place of issue
Patient's name, age, sex and address
Patient's signature or thumb impression, taken in your presence before you fill the rest
At least one identification mark; the form has space for two
What the patient is suffering from
What they are unfit for: duty, work or classes
Number of days, the first and last day, and that both days are counted
The date treatment began, if you have been treating the patient
Nature and probable duration of the illness
Your name, qualifications, registration number and council, and your signature
A copy filed and the register entry made
The visit behind the certificate
Vitels keeps each patient's visits and prescriptions in one record, printed on your letterhead with the registration number, so the treatment dates are there when an office queries a certificate. Vitels itself does not print certificates; this free tool does.
Straight answers
What is an unfit certificate?
A medical certificate stating that a person is, because of illness, unfit to attend duty, work or classes for a stated period. In India it is the leave certificate of Appendix 2 to the 2002 regulations, which certifies that a period of absence from duty is necessary for the restoration of health. Offices and colleges often call it an unfit certificate.
Is an unfit certificate different from a sick leave certificate?
In substance, no. Both certify the illness and the period of absence. The unfit wording says plainly what the patient cannot do and gives a first and last day, which offices find easier to process. Use the medical certificate maker if the employer asks for the Appendix 2 wording as it stands.
Will a central government office accept a private doctor's unfit certificate?
For a non-gazetted employee, rule 19(1)(ii) of the CCS (Leave) Rules lets a registered medical practitioner give Form 4 when a CGHS beneficiary falls ill away from the CGHS area or headquarters and no Authorised Medical Attendant is available within eight kilometres. Otherwise the employee goes to a CGHS dispensary, a government hospital or the Authorised Medical Attendant. The leave sanctioning authority decides.
Does the patient need a fitness certificate to rejoin?
Under rule 24(3)(a) of the CCS (Leave) Rules, a central government servant who took leave on medical certificate may not return to duty until they produce a fitness certificate in Form 5. Private employers set their own rule. The fitness certificate maker prints the fit to join duty wording.
Can I write that the patient needs a change of place?
Not on a central government leave certificate unless the office asks for it. Note 2 to Form 4 says the certifying officer is not at liberty to certify that the employee requires a change from or to a particular locality; such certificates are given only at the explicit desire of the administrative authority.
Does the tool store patient 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 patient 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 Central Civil Services (Leave) Rules, 1972 as updated on 24.09.2024; it is general information, not legal advice. State governments and private employers have their own leave rules. Sources: nmc.org.in and doptcirculars.nic.in, accessed 26 Oct 2026.