Foremed Clinic

420 Columbia St., New Westminster, BC, V3L 1B1
Ph: 604 522 2206 Fax: 604 522 7206

Certificate of Health Status
2026-02-05

Doctor Gbogboade Ademiluyi (68199)
CPSID 43560
MSP ID 68199

To Whom this may concern:

RE: HOLAND, MARK THOMAS
DOB: 04/09/1978 (d/m/y)

Dear Sirs, Mesdames,

This patient was seen at this clinic today with a complex and significant medical problemiillness. A prolonged absence
from work is necessary to allow the patient to recover. The return to work date is estimated to be one month from today,
pending medical reassessment.

as

Signed: Gbogboade Ademiluyi (68199)