![](https://www.pdfsearch.io/img/58eb80c29b1d8a223f4271a31d39e9c7.jpg) Date: 2013-03-28 10:50:20
| | Certification of Health Care Provider for Employee’s Serious Health Condition (Family Medical Leave Act) Employee Number: Part A For Completion by the Employee: Name: Department: Add to Reading ListSource URL: bhr.sd.govDownload Document from Source Website File Size: 230,83 KBShare Document on Facebook
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