831.21  Forging or counterfeiting doctor's certificate of examination.--Whoever falsely makes, alters, forges or counterfeits any doctor's certificate or record of examination to an application for a policy of insurance, or knowing such doctor's certificate or record of examination to be falsely made, altered, forged or counterfeited, shall pass, utter or publish such certificate as true, with intent to injure or defraud any person, shall be deemed guilty of forgery, and upon conviction thereof shall be punished by imprisonment in the state penitentiary not exceeding 5 years, or by fine not exceeding $500.