Patient Information

Medical Report

Guidelines in Applying

1. Medical Report
   • Applicant/ patient must fill Borang Keizinan Permohonan Laporan Perubatan/ Surat Perakuan Perubatan (BKMIS-E034-E06) Please submit together with:
     1. Copy of Identity card
     2. Copy of UMMC Treatment Card
     3. Copy of Medical Leave Certification (if needed)
   • For patient under 18 age, Next of Kin/ Guardian must completed Borang Keizinan Permohonan Laporan/Surat Perakuan Perubatan (BK-MIS-034)
     
     
2. Post Mortem Report
   • Applicant must fill in Borang Keizinan Permohonan Laporan Perubatan/ Surat Perakuan Perubatan (BKMIS-E034-E06)
   • Please submit together with:
     1. Copy of Identity card
     2. Copy of UMMC Treatment Card (if any)
     3. Copy of next of kin identification card
     4. Foreigner applicants: To submit consent letter from Embassy.
        
        
3.  Insurance Claim Purpose
   (Ward admission, Accident. Labour Form and PKS6 Form)
   • Applicant must fill in Borang Keizinan Permohonan Laporan Perubatan/ Surat Perakuan Perubatan (BKMIS-E034-E06)
   • Please submit together with:
     1. Copy of Identity card
     2. Copy of UMMC Treatment Card (if any)
     3. Copy of Medical Leave Certification (if needed)
        
        
4. Confirmation Medical Leave Certificate/ Sick Acknowledgement To Attend in Court
   • Applicant must fill Permohonan Pengesahan Sijil Cuti Sakit form (BK-MIS-036-E01)
   • Please submit together with:
     1. Copy of Identity card
     2. Copy of UMMC Treatment Card (if any)
     3. Original Copy or Copy of Medical Leave Certification for confirmation
        
        
5. Specialist Medical Report
   • Applicant must fill in Borang Keizinan Permohonan Laporan Perubatan/ Surat Perakuan Perubatan (BKMIS-E034-E06)
   • Patient required to attend an examination on given date
   • Fee of RM 500.00 is required for advance payment. Upon completion of Specialist Report, the remaining charges will be informed.

CHARGES

*Non-Citizen will be charged double than the citizen charge rate
*New Charges Started 1 August 2021

Address:
Ketua Jabatan
Jabatan Maklumat Pesakit
Tingkat 1, Bangunan Kecemasan
Pusat Perubatan Unversiti Malaya (PPUM)
59100 Lembah Pantai
Kuala Lumpur

Contact No : 03-7949 4315/2228
Fax No : 03-7954 1204
Emai : lp.jmp@ummc.edu.my