How to Draft a Special Medical Leave Application for an Employee Injured in an Accident?

djjk
Hi,

One of our employees met with an accident while returning home after duty. As he got some minor injuries, his doctor suggested one month of bed rest. Hence, he informed us that he could rejoin for duty only after 2-3 weeks. Can anyone send me a draft copy of a 'Special Medical Leave Application without Pay' which he needs to fill as soon as he rejoins?
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