Nr. de nregistrare:

Data eliberrii:EXTRAS MEDICAL DE LA DOMICILIUn legtur cu participarea la concursul pentru ocuparea funciei de procuror, se solicit certificatul medical pentru concurentul _______________________________

(nume, prenume, anul naterii,

_____________________________________________________________________

domiciliul)

Medicul de familie:

Medicul_______________________________L..___________________________

Medicul narcolog:

Prin prezentul se confirm, c cet._____________________________________________La eviden narcologic____________________

_______________________________________

_______________________________________

Medicul_______________L..____________

Medicul psihiatru:

Prin prezentul se confirm, c cet.____________

_________________________________

La eviden la psihiatru____________________

_______________________________________

_______________________________________

Medicul_______________L..____________

Medicul ftiziolog:

Prin prezentul se confirm, c cet.____________

_________________________________

La eviden la ftiziolog____________________

_______________________________________

_______________________________________

Medicul_______________L..____________

Medicul infecionistPrin prezentul se confirm, c cet.____________

_________________________________

La eviden la infecoinist_________________________________________________________

_______________________________________

Medicul_______________L..____________

eful policlinicii

_________________L..____________