Guidelines for issuing a Medical Certificate 

(a) Medical certificates are legal documents. Medical practitioners who deliberately issue a false, misleading or inaccuratecertificate could face disciplinary action under the Indian Medical Council (Professional Conduct, Etiquette and Ethics), Regulations, 2002. 
b)   The certificate should be legible, written on the doctor’s letterhead and should not contain abbreviations or medicaljargon.
 The certificate should be based on facts known to the doctor. The certificate may include information provided by the patients but any medical  statements must be based upon the doctor’s own observations or must indicate the factual basis of those statements. 
C) The certificate should:-
1. Indicate the date on which the examination took place 
2. Indicate the degree of incapacity of the patient as appropriate 
3. Indicate the date on which the doctor considers the patient is likely to be able to return to work
4. Be addressed to the party requiring the certificateas evidence of illness e.g. employer, insurer, magistrate Indicate the date the Certificate was written and signed.
5. Name, signature, qualifications and registered number of the consulting Registered Medical practitioners 
6. The nature and probable duration of the illness should also be specified. 
7. This certificate must be accompanied by a brief resume of the case giving the nature of the illness, its symptoms, causes and duration.
8. The medical certificate under normal circumstances, as a rule, should be prospective in nature i.e. it may specify the anticipated period of absence from duty necessitated because of the ailment of the patient. However, there may be medical conditions which enable the medical practitioner to certify that a period of illness occurred prior to the date of examination.
9. Medical practitioners need to give careful consideration to the circumstances before issuing a certificate certifying an illness prior to the date of examination, particularly in relation to patients with a minor short illness which is not demonstrable on the day of examination and should add supplementary remarks, where appropriate, to explain the circumstances which warranted the issuances of certificate  retrospective in nature.
10. It is further observed that under no circumstances, a medical certificate should certify period of absence from duty, for a duration of more than 15 days. In case the medical condition of the patient is of such a nature that it may require further absence from duty, then in such case a fresh medical certificate may be issued.
11. Record of issuing medical certificate-Documentation should include: Patient to put signature/ thumb impression on the medical certificate . Identification marks to be mentioned on medical certificate That a medical certificate has been issued 
12. An official serially numbered certificate should be utilized. The original medical  certificate is given to the patient to provide the documentary evidence for the employer. The duplicate copy will remain in the Medical certificate book

We can deny it ….. only patient can apply for the certificate. Patient’s consent is essential to issue a certificate. 
You can also say that…… you would like to examine again before you issue a certificate again because …… there is a possibility of change in diagnosis…… hence request the family to bring the patient

Finally…… if you have to issue 
Request the medical board of your hospital to help you. A board can issue

Certificate can also be issued about the past and mentioning…… that *I have not examined him or seen in the past two years* hence *the treating psychiatrist needs to examine the patient before a final certificate is issued*

*very important note for all psychiatrist*
Never issue a mentally normalcy certificate ……. first time when you assess a person for some vague reason. 
Please use negative language…. when issuing a negative or normalcy certificate ….. for example *on detailed examination dated …. I couldn’t find a signs and symptoms of severe mental disorder* for confirmation patient needs to be admitted inpatient and evulated for a period of 2 to 3 weeks

Signatures or thumb impression of patient are essential on body of certificate which should never be affixed involuntarily and hence certificate cannot be issued against consent of the patient. 

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