Translation of Certificate from hospital

 

OSTROH REGIONAL HOSPITAL

Outpatients’ clinic

STAMP

Ministry of Health Protection of Ukraine

 

 

CERTIFICATE #9

 

 

issued to citizen

year of birth

to certify that her mother —- (1923 year of birth) is really ill, is not able to ambulate without assistance and requires nursing.

diagnosis: chronic ischemic disease of the heart. Cardiac fibrillation. Atherosclerotic coronarocardiosclerosis of the I-II level.

 

Seal

DOCTOR

—.

The certificate is issued at demand.

—-

 

 

Seal

Ministry of Health Protection of Ukraine

— hospital,

outpatients’ clinic

— region, — oblast

Doctor —-

Head of the Outpatients’ clinic Signature —-