[Clinic/Hospital Name]
[Clinic/Hospital Address]
[Phone Number]
[Email]
Date:
To Whom It May Concern,
Subject: Medical Visa Referral for [Patient Name]
Dear Sir/Madam,
This is to certify that [Patient Name], [Age], [Gender], holding passport number [Passport Number], has been under my care at [Clinic/Hospital Name].
Diagnosis:
History & Examination Findings:
Treatment Provided:
Reason for Referral:
In view of the above, I am referring [him/her/them] for further management and treatment abroad. I kindly request that the necessary medical visa be granted to [Patient Name] for travel to [Country Name] for medical care.
If you require any additional information, please do not hesitate to contact me.
Sincerely,
[Doctor's Name]
[Qualifications]
[Registration Number]
[Department]
[Clinic/Hospital Name]
[Signature]