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SC Malattie Infettive e Tropicali I, osp. Amedeo di Savoia, Torino SS Medicina dei Viaggi
ASL Città di Torino

Certificati medici



Esenzione dalle vaccinazioni
Necessità di siringhe sterili
Farmaci in uso per malattie croniche
Certificato di negatività di anticorpi anti-HIV e assenza
 di malattie infettive

  Certificato per portare con sé prodotti di medicazione e siringhe monouso

 


Esenzione dalle vaccinazioni (febbre gialla)

 

MEDICAL CONTRAINDICATION TO VACCINATION
Contre-indication mèdicale à la vaccination


This is to certify that immunization against
Je soussigné certifie que la vaccination contre

Yellow Fever (Fievre Jaune)

for
pour

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

is medically contraindicated because of the following conditions:
est médicalement contre-indiquée pour les raisons suivantes:

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

Date.......................  
 


 


Necessità di siringhe sterili 

Sterile needle and syringe permission letter

Name 
Destination                                                        Date

The traveller named above is my patient and under my medical care and must carry a supply of medically approved sterile needles and syringes for use in any medical emergency. These needles and syringes are packed in a sterile condition and are never to be carried loosely. 

Best regards, Sincerely, 
 


    


Farmaci in uso per malattie croniche 

Medication requirement letter 

Name 
Destination                                                        Date

The traveller named above is my patient and under my medical care and requires the following prescription medications while travelling. These medications are required for the following medical conditions: 

Malaria prevention 
Diarrhea 
Hypertension 
Allergy 
Diabetes 

Best regards, Sincerely,



Certificato di negatività di anticorpi anti-HIV 
e assenza di malattie infettive 

Communicable diseases and HIV status letter 

Name 
Destination                                                        Date

The traveller named above is my patient and under my medical care. This individual is free of any contagious or communicable diseases. A test for AIDS (HIV, Acquired Immunodeficiency Sindrome) was recently performed and was negative. Enclosed a copy of that negative result.  

Best regards, Sincerely, 
 



Certificato per portare con sé 
prodotti di medicazione e siringhe monouso


Name
Destination

                     Date

I, ..............., MD, certify, that
Mr/Mrs/Miss ........................
Carries with him/her a medical Kit that includes syringes and needles to be used by a doctor, during his/her trip in case of emergency.

These are recommended for personal use only to avoid the risk of accidental transmission of infectious diseases.

They are not to be sold.

Best regards, Sincerely,
 


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