Medical certificate
to supplement an Advance Medical Directive
Mr. Walter Keim, born: March 25, 1948, address: Almbergskleiva 64, NO-6657 Rindal, presented himself here today for a medical examination, for the sole purpose of determining his current legal capacity, and then to issue a legally binding declaration of will in the form of a Advance Medical Directive.
It is hereby stated in the sense § 104 German Civil Code that no disturbances of his mental activity are to be seen at Mr. Keim, which would indicate a restriction of his full legal capacity. There is also no history to suggest that there was such a risk at an earlier point in time.
Expressed positively: Mr. Keim can be diagnosed as a normal psychological finding and is therefore fully capable of forming free wills and an Advance Medical Directive.pursuant to § 1901 a German Civil Code.
Dr. XXXXX