(Sample) Authority Letter to Pick up My Medical Result Report

A person may not always be in a situation to collect his medical test's result reports from the hospital/medical institution. In that case, he can very well authorize someone else on his behalf to pick up the documents for him.

Two things could be very important here - to make it work:
(1) The person, who is authorizing, should give his self attested copy of any identity proof;
(2) The authorized person should carry his original identity proof as well as a self attested copy.

These will help the hospital/medical institution to verify the authenticity of both the person and would enable them to give the medical reports without any hesitation.

Modify the following format suitably.

FORMAT

Date: ................

From

(Name of the Person)

(Resident Address)

(Tel. No. ..............)

(Email id. ...............)

To

(Name of the Officer)

(Designation)

(Name of the Hospital/Medical Institution)

(Address, Tel. No. ............)

Sub.: Authority to collect medical results on my behalf

Dear Sir/Madam,

I had recently undergone some medical tests at your hospital/clinic as advised by my doctor. Following are my personal and tests details for your kind reference.

Name: .............................

Date of birth: ....................

Address: ............................

Medical tests done on (date)

The payment acknowledgement copy is enclosed herewith.

I am presently very sick and hence I am not in a position to visit your hospital/clinic personally to collect the report on the medical tests results done on me that day.

Therefore, I am hereby authorizing the following person who will collect the documents on my behalf.

Authorized Person's Name: ..................

Signature: ...............

He will be visiting the hospital/clinic tomorrow to collect the medical reports. Kind request to your goodself to please hand over the necessary documents and certificates to him without fail.

A copy of my identity proof self attested by me is enclosed herewith for verification purposes.

Thanking you for your cooperation!

Yours faithfully,

  signature

(Name of the Person)

Encl: A/a