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certificat medical

certificat medical

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Published by horacio

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Published by: horacio on Nov 16, 2007
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12/09/2012

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Nr. …….

din ……………
CERTIFICAT MEDICAL


In baza referatului Dr. ………………………………………………………………..
in calitate de ………………………………
(numele si prenumele)

Se certifica : Dl. (Dna) …………………………………………………………………………..
in ar!ta de ….. ani" !e# ….. " d$%iciliat in : l$calitatea ………………………&ud……....……..
!tr. ……………………….. nr. …. cu C. I. !eria ….. nr. ……….
aand $cu'atia de ………………………….

E!te !uferind de : ……………………………………………………………………………….
………………………………………………………………………….…………………………….
………………………………………………………………….…………………………………….
…………………………………………………………………….………………………………….

S(a eliberat 'rezentul !'re a(i !eri la …………………………………………………………

(semnatura si parafa)

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