Medical Excuse Slip
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1Medical Excuse Slip
[Doctor’s Name]
[Address]
[City, State Zip Code]
[Phone Number]
Date: ____/____/______
Please Excuse: ______________________________________________
From:
[__] Work
[__] Other__________________________________________________
Due To:
[__] Injury
[__] Illness
[__] Other__________________________________________________
For the following dates:
____/____/______ - ____/____/______
Thank You,
__________________________
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Parent category: Medical