Medical certificate (single-parent household, etc.)
Update date: April 1, 2024
It is in PDF file format, so please print it out and use it.
Note: Plain paper is recommended for printing paper, and A4 is recommended for printing size.
Thermal paper for thermal printers cannot be accepted.
Application for medical assistance for single-parent families (PDF: 100KB)
[Example] Application for medical assistance for single-parent families (PDF: 132KB)
Documents that can be submitted by mail
The above documents can also be submitted by mail.
Please check the attached documents on the website and submit them without any omissions, seal omissions, or incomplete attachments.
Points to note when submitting by mail
The reception date by mail will be the date the application/notification arrives at the city hall.
In order to avoid postal accidents, we recommend sending by special record/simple registered mail.
In addition, if there are any deficiencies in the application or notification, we will contact you by phone or letter at a later date. Be sure to fill in your address, name and phone number.
Adobe Acrobat Reader DC (formerly Adobe Reader) is required to open PDF format files.
If you don't have it, you can download it for free from Adobe.
Download Adobe Acrobat Reader DC
Inquiries about this page
Inagi City Child Welfare Department Child Care Support Division
2111 Higashi Naganuma, Inagi City, Tokyo
Phone: 042-378-2111 Fax: 042-377-4781
