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PH SSS MED-01688 2000 free printable template

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Republic of the Philippines SOCIAL SECURITY SYSTEM MEDICAL CERTIFICATE (SSS FORM MID 102) 1. EMPLOYEE S GENERAL DATA NAME (Last, First, M.I.) AGE SEX CIVIL STATUS OCCUPATION DATE EXAMINED/ATTENDED
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How to fill out sss medical certificate form:

01
Start by obtaining the official sss medical certificate form from the designated authority.
02
Fill in your personal information accurately and completely in the designated fields. This includes your full name, date of birth, address, contact information, and any other details required.
03
Provide details about your medical condition or illness that requires certification. Be clear and concise in describing your symptoms or diagnosis.
04
If applicable, attach any relevant medical documents or test results that support your condition.
05
Fill in the necessary dates, including the date of examination, diagnosis, and treatment, if applicable.
06
If the medical certificate is required for an employer or insurance claim, ensure to provide the necessary contact information or documentation requested.
07
Review the form thoroughly for any errors or missing information before submitting it.
08
Sign and date the form as required.

Who needs sss medical certificate form:

01
Individuals who require medical certification for their employer, insurance claims, or any other official purposes.
02
Employees who need to take sick leave and are required to provide documentation of their medical condition.
03
Individuals applying for disability benefits or government assistance programs that require medical certification.

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Laws calm legal forms guide a form I — 94 is a document used by the US Customs and Border Patrol for an application for documenting the arrival and departure records of foreign nationals entering the US on non-immigrant visas the form is used to document non-immigrant visas such as student work or visitor visas in this case we are using the form I — 94 provided by the Customs and Border Patrol examples of the form I — 94 can be found online however you must use the form that is provided by your transportation carrier the first step in completing the form is to enter your admission number on the top of the card the form must be completed in English using one letter for each space provided the space is small, so it is important that you write neatly, and legibly you must again put your admission number above your first arrival record under the arrival record put your last name first name date of birth country of citizenship sex passport number flight number and residency information you must also put where your visa was issued and the date followed by any address you will be using in the United States once the arrival section is completed the applicant must present the card to the customs officer which will be reviewed and stamped for entry in the United States the arrival portion will be retained by the US Customs Service and you will be given a stamped portion of the departure section the stamp will indicate the last date you can legally be in the United States you must retain this part of the form and present it upon your departure do not write in the back portion of the form i-94 this is for US government use only to watch more videos please make sure to visit laws comm

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A Social Security System (SSS) Medical Certificate Form is a form required by the Social Security System in the Philippines when claiming for sickness benefits. The form must be completed by a physician and submitted to the SSS in order to be eligible for the benefit. It includes information about the diagnosis, treatment, and prognosis of the illness.
1. Fill in the name of the patient and the SSS Number in the appropriate boxes. 2. Enter the date of the medical certificate. 3. Fill in the name of the attending physician and the address of the clinic. 4. Enter the diagnosis of the patient and the period of disability. 5. Enter the name of the employer and the number of days the patient has been absent from work. 6. Enter the number of days the patient is expected to be unable to work due to illness. 7. Enter the certification of the attending physician. 8. Enter the signature of the attending physician and the date of the medical certificate.
The information that must be reported on an SSS Medical Certificate form includes: the employee's name, date of birth, address, contact information, nature of illness, duration of illness, treatment given, and the doctor's diagnosis.
The penalty for the late filing of an SSS Medical Certificate Form is a fine of up to PHP 500.
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