شهادة طبية للزواج الجزائر Word

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شهادة طبية للزواج الجزائر Word

شهادة طبية للزواج الجزائر Word

مرحبا بك في مدونة معلمي؛

نقدم لك شهادة طبية للزواج الرسمية بالجزائر بصيغة Word قابلة للتعديل

نموذج لشهادة طبية ما قبل الزواج بالجمهورية الجزائرية

شهادة طبية ما قبل الزواج

(معـدّة تطبيقـا لأحكـام المادة 7 مكـرر مـن القانون رقــم 84-11 المؤرخ فـي 9 يونيـو سنـة 1984 والمتضمن قانون الأسـرة )

أنا المضي أسفله الدكتور:.......

الاسم و اللقب: ...

دكتور في الطب: ...

الممارس في: ..........

العنوان: .....

أشهد أني فحصت لغرض الزواج: ..........

المولود(ة) في : ...............

الساكن(ة) ب: ...........

بطاقة التعريف الوطنية رقم: ................... الصادرة في: …………. ب:…………….

أعددت هذه الشهادة بعد فحص عيادي شامل بعد الاطلاع على نتائج الفحوص الآتية: …

فصيلة الدم (....................)

أصرح كذلك أنني:

- أعلمت المعني (ة) بنتائج الفحوصات الطبية التي خضع (ت) لها و بكل ما من شأنه أن يقي أو يقلل الخطر الذي قد يلحق به أو بزوجه أو بذريته.

- لفت انتباه طالبة الزواج إلى مخاطر مرض الحميراء الذي يمكن أن تتعرض له أثناء فترة الحمل.

- أكدت على عوامل الخطر بالنسبة لبعض الأمراض.

- سلمت هذه الشهادة للمعني (ة) شخصيا لاستعمالها و الإدلاء بها في حدود ما يسمح به القانون.

حررب........في....

تحميل Word

شارك المقال لتنفع به غيرك

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