FORM 9: FINAL CERTIFICATE (CONFIDENTIAL) Regulations 58 and 89-A Signature/ thumb impression of insured person.____________ Deposit this certificate within 3 days with local office to avoid possible loss of benefit under regulation 64 Book No ___________ Stamp of the dispensary Serial No __________ To _______________ Insurance No ______________ Date of first certificate of spell of sickness or disablement ________________________ I certify that I have examined you today and that in my opinion you have continued to need medical treatment and attendance and abstention from work on medical grounds up to and including this day by reason of _______________ cause group No _________________________ In my opinion you will be fit to resume work tomorrow/on 1_______________ Date ____________ Signature ____________ Insurance Medical Officer (Rubber stamp or name in block letters) Any other remarks by the Medical Officer ____________________ Delete if not applicable. | 
