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The Social Security (Medical Evidence) Regulations 1976
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Changes over time for: PART II
Version Superseded: 28/09/2001
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- 04/10/1976- Amendment
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[F1[F2PART IIFORM OF CERTIFICATE
Textual Amendments
F1Sch. 2 substituted (6.4.1987) by The Social Security (Medical Evidence) Amendment Regulations 1987 (S.I. 1987/409), regs. 1(1), 4
F2Sch. 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 than 14 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 UKCC Personal Identification Number and the expiry date of your registration with the UKCC. | |
| Date of signing ......./........../........ | ___________________________________ |
|---|---|
| Signature: | Doctors: Please stamp your name and address here if the form has not been stamped by the Family Health Service Authority in whose medical list you are included]] |
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