To
The Head-Master/Principal
(give your school/college name here), Balasore
Sir,
With due respect and humble submission I (give your name) begs
to state that I was unable to attend the class last day/yesterday/from
18-06-1993 to 20-06-1993 because of suffering from serious fever/stomach
pain/others. Therefore I pray that you will be good and kind enough to grant my
application and leave me a fine for nonattendance I shall remain ever great
full to you.
Your's
Obedient Student
(give your name here)
Date : 18-June-1993 (it should be your application
issue date)