Medical certificate form for confinement, miscarriage, maternity-related illness, and delivery certification under labour law. A prescribed medical certificate form is used to certify a woman employee's confinement, miscarriage, medical termination of pregnancy, tubectomy operation, delivery of a child, or illness arising out of pregnancy, delivery, premature birth, or miscarriage. The form also provides for certification of death before, during, or after confinement and whether the child survives, and it may be completed by specified medical or authorised local officials. The form requires the examiner to state the relevant dates and condition, strike out inapplicable portions, and sign with designation.