Alexander Ribush's medical attendant certificate

This is a certificate, issued to my maternal grandfather, Alexander Ribush in Pskov in 1918. It reads:

'In the course of examination at... (illegible handwriting) under the program, attached to the Order for the Military Department, dated 1873, evinced the following success:
Anatomy and Physiology - highest
External and internal illnesses - highest
Novelty - good
Fractures and dislocations - highest
Minor surgery - highest
Patients and wounded nursing - highest
First aid rendering, taking care of sudden sicknesses and sudden deaths - good
Pharmacy and pharmacology - highest
Knowledge of the Latin language - highest
Taking into consideration such knowledge in the art of medical attendant's subjects ?
the Commission designates to recognize him worth to be appointed army medical attendant. This Certificate is issued to acknowledge the aforementioned.'