Medical Report

 Patient (Self)

• Application form HKL/JRP/ML-102 (Pind.1/2019)
• A copy of the patient's identity card / passport
• A copy of the patient's appointment card/ Discharge Note/ Hospital Bill
• Fee (according to the type of application)
• Related forms (Insurance/ KWSP/ PERKESO/ ‘Buruh’ 90 ect)
• Other documents (related to application / treatment)

 Mother / Father / Guardian (Patients under 18 years old)

• Application form HKL/JRP/ML-102 (Pind.1/2019)
• Original consent letter from the parent / legal guardian
• A copy of the patient's birth certificate
• A copy of the patient's identification card / the patient's passport
• A copy of ID card / passport of valid mother / father / guardian
• A copy of the patient's appointment card/ Discharge Note/ Hospital Bill
• Affidavit (related)
• Payment (according to the type of application)
• Related forms (Insurance/ KWSP/ PERKESO/ ‘Buruh’ 90 ect)
• Other documents (related to application / treatment)

 Heirs (Husband / Wife / Children / Siblings / Mother / Father)

 (For deceased patients)

• Application form HKL/JRP/ML-102 (Pind.1/2019)
• Original consent letter from the legal heir
• Copy of birth certificate / identity card / passport of the deceased
• Copy of birth certificate / identity card / passport of valid heir
• Copy of death certificate / burial permit of the deceased
• Copy of the deceased's appointment card/ Discharge Note/ Hospital Bill
• A copy of the marriage certificate (if Applicable)
• A Copy of birth certificate (if Applicable)
• A valid heir declaration letter (if Applicable)
• Payment (according to the type of application)
• Related forms (Insurance/ KWSP/ PERKESO/ ‘Buruh’ 90 ect)
• Other documents (related to application / treatment)

 Representative / Agent ( Insurance / Lawyer / Others )

• Application through writing or application form HKL/JRP/ML-102 (Pind.1/2019)
• Original consent letter from the patient / legal next of kin
• Original permission letter from the embassy of the patient / the deceased
• Letter of consent of the representative to obtain a medical report
• Other documents that refer to the following status :

1. Patient
2.  Mother / Father / Guardian
3.  Heir

 Exceptions to Letter of Authorization and Payment

Applies to agencies that have been authorized under the provisions of the law for the purpose of investigation such as:

1.  Royal Malaysian Police
2.  Court
3.  Any agency that has been authorized under the provisions of the law to obtain a patient's medical report.

 Report Type

Payment Charges

Prepared By

Citizen

Foreigner

Regular Medical Report

RM 40.00

RM 80.00

Medical Officer

Specialist Summary

RM 80.00

RM 240.00

Specialist

Specialist Detail Report

RM 200.00

until

RM 1,000.00

RM 400.00

until

RM 2,000.00

Specialist

Clinical Post Mortem

RM 1,000.00

RM 2,000.00

Specialist

Xray Report

RM 80.00

RM 240.00

Specialist

Radiology Report

RM 200.00

Until

RM1,000.00

RM 400.00

Until

RM 2,000.00

Specialist

Report A Second Copy of The Original Report

50% from the original charge rate

Medical Officer/ Specialist

Re-Adjustment Report

Payment according to the original / full charge

Medical Officer/ Specialist

Clarification / Correction Report

Free

Medical Officer/ Specialist

Medical Report by Police / Government Department / JKM / Legal Aid Bureau / BAT Form F117 (Military)

Free

Medical Officer/ Specialist

 Day

Open

Close

Monday – Thursday

8.00 am – 1.00 pm

2.00 pm – 4.30 pm

1.00 pm – 2.00pm

Friday

8.00 am – 12.15 pm

2.45 pm – 4.30 pm

12.15 pm – 2.45 pm

Saturday, Sunday & Public Holiday

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