MEDICAL LEAVE APPLICATION

Subject: Application For Medical Leave                                                  

                                                                                                                                      

 Dear Sir,

 I wish to communicate that while returning home from office I met with a Minor/ serious road accident. This accident has caused fracture/ multiple fractures in my left/ right leg and presently I am admitted to (name of the hospital) hospital. On 16^th April (or exact date) I could undergo a minor/major orthopedic operation.

   

   Hence please grant me leave from 13^th – 28^th April 2013 (or exact period). For this act of kindness I would be thankful to you.

Regards

Name:

Designation:

Emp. Code: