Prayer Application Before Medical Leave

Medical Leave Application Form

District:

Circle:

School Name:

School is administered by: The Head Teacher The Teacher-In-Charge

Salutation: Sir Madam

Leave Taken From Date (DD-MM-YYYY):

Leave Taken To Date (DD-MM-YYYY):

Number of Leave Days:

Teacher’s Name:

Designation: an Assistant Teacher the Head Teacher

Brief description about the medical condition:

Application Date (DD-MM-YYYY):

Enclosures (if any, one per line):