ANNEXURE A

(See clause 15 A - Sick leave)

CERTIFICATE REQUIRED IN TERMS OF THE BARGAINING COUNCIL AGREEMENT FOR

THE FOOD RETAIL, RESTAURANT, CATERING & ALLIED TRADES

* I, ............................................................................

residing at ................................................................

hereby certify that … ................................................

has been under my treatment from … .............to ......

and that he is suffering from

§ .............................................................................

I further certify that he is in consequence unable to perform his official duties, and I consider it essential for the recovery of his health that he should have leave

from .............................. to.....................................

for the purpose of ..................................................

Date .......................................................................

...........................................

Signed: Medical practitioner

________________________________________

* Name and qualification of practitioner

… Name and occupation of patient

… Period

§ The nature of the illness, disease or injury to be stated as far as possible in non-technical terms with concise particulars as to history, symptoms and severity, and ascertainable cause.