xxx:

This is to certify that XXX, male, was born on, and is a villager in this village. Judging from the diagnosis of fever, the villager has a fever of xx degrees. This is to certify that.

Hereby certify that

Village name:

Signature of person in charge or personnel:

Village account

Phone number of the person in charge or supervisor:

Village address and official seal:

Date of issue: