The Social Security (Medical Evidence) Regulations 1976

[F1 [F2 PART II FORM OF CERTIFICATE

Textual Amendments

F1 Sch. 2 substituted (6.4.1987) by The Social Security (Medical Evidence) Amendment Regulations 1987 (S.I. 1987/409), regs. 1(1), 4

F2 Sch. 2 Pt. II substituted (1.11.1991) by The Social Security (Miscellaneous Provisions) Amendment Regulations 1991 (S.I. 1991/2284), regs. 1, 22

MATERNITY CERTIFICATE

Please fill in this form in ink Name of patient _________________________________
Fill in this part if you are giving the certificate before the confinement.	Fill in this part if you are giving the certificate after the confinement.
Do not fill this in more [F3 than 20 weeks] before the week the baby is expected.	I certify that I attended you in connection with the birth which took place on ......./........../....... when you were delivered of a child [__] children.
I certify that I examined you on the date given below. In my opinion you can expect to have your baby in the week that includes ......./........../........	In my opinion your baby was expected in the week that includes ......./........../........
"Week": This means the 7 days beginning on a Sunday.
Date of examination ......../........../........	Registered midwives:
	Please give your [F4 NMC] Personal Identification Number and the expiry date of your registration with the [F4 NMC].
Date of signing ......./........../........	___________________________________
Signature:	Doctors: Please stamp your name and address here if the form has not been stamped by the F5 [F6 Primary Care Trust or Local Health Board in whose medical performers list you are included (or, in Scotland, by the Health Board in whose primary medical performers list you are included)]]]

Textual Amendments

F3 Words in Sch. 2 Pt. II substituted (28.9.2001) by The Social Security (Medical Evidence) and Statutory Maternity Pay (Medical Evidence) (Amendment) Regulations 2001 (S.I. 2001/2931), regs. 1, 2(3)(a)

F4 Word in Sch. 2 Pt. II substituted (1.8.2004) by The Health Act 1999 (Consequential Amendments) (Nursing and Midwifery) Order 2004 (S.I. 2004/1771), art. 1(1), Sch. para. 56(b)

F5 Words in Sch. 2 Pt. II substituted (1.4.2004) (W.) by The General Medical Services and Personal Medical Services Transitional and Consequential Provisions Order 2004 (S.I. 2004/865), art. 1(1), Sch. 1 para. 1(3)

F6 Words in Sch. 2 Pt. II substituted (1.4.2004) (E+S+NI.) by The General Medical Services Transitional and Consequential Provisions (Wales) (No. 2) Order 2004 (S.I. 2004/1016), art. 1(1), Sch. 1 para. 1(3) (with art. 83)