Довідка є в медичній картці.

Yes. Є is the present-tense form of бути (to be), and here it means something like is / exists.

So Довідка є в медичній картці literally feels like:

• The document is in the medical record
• or There is a document in the medical record

In Ukrainian, present-tense to be is often omitted in simple sentences, so you will also very commonly hear:

Довідка в медичній картці.

That is natural too. Using є can make the sentence sound a bit more explicit or formal.

Usually, yes.

Both of these are possible:

• Довідка є в медичній картці.
• Довідка в медичній картці.

In everyday Ukrainian, the version without є is very common. The version with є can sound a little more formal, careful, or emphatic.

A useful rule of thumb:

• if you are simply identifying or describing something in the present, Ukrainian often drops is/are
• if you want to stress existence or be more explicit, є may appear

Because after в meaning in, Ukrainian uses the locative case for location.

The dictionary form is:

• медична картка = medical card / medical record

But after в when you mean in, it changes to locative:

• в медичній картці

So both words change because they must match in case:

• медична → медичній
• картка → картці

Because картка is a feminine noun, and in the singular locative case its ending changes.

Pattern:

• nominative: картка
• locative: у/в картці

This kind of change is normal for many feminine nouns ending in -ка.

Also notice the consonant shift:

• к often becomes ц before certain endings

So:

• картка → картці

You do not need to predict every change perfectly at first, but this is a very common pattern.

Because adjectives in Ukrainian must agree with the noun they describe in:

• gender
• number
• case

Here the noun картці is:

• feminine
• singular
• locative

So the adjective must also be:

• feminine
• singular
• locative

That gives:

• медична картка → в medичній картці

So the adjective changes because the noun changes.

Довідка is in the nominative singular.

It is the grammatical subject of the sentence:

• Довідка = the thing being talked about
• є = is
• в медичній картці = in the medical record

So the structure is:

• subject in nominative: довідка
• location in locative: в медичній картці

Довідка can mean several related things depending on context, such as:

• a certificate
• an official note
• a statement
• a medical note
• a reference document

In medical or administrative contexts, it often means some kind of official paper confirming information.

So even if the English translation is already given, it is good to know that довідка is broader than just one fixed English word.

Yes, in this kind of sentence в and у usually mean the same thing: in.

Ukrainian often alternates between в and у for ease of pronunciation and smooth sound. This is called euphony.

So both of these are possible:

• в медичній картці
• у медичній картці

The choice often depends more on sound than on grammar.

Yes. Ukrainian word order is more flexible than English word order.

For example:

• Довідка є в медичній картці.
• У медичній картці є довідка.

Both are grammatical, but the emphasis changes a bit.

• Довідка є в медичній картці focuses first on the document
• У медичній картці є довідка focuses first on where it is

English often has to rely on word order more strictly, but Ukrainian can move parts around for emphasis.

Because Ukrainian has no articles.

English distinguishes:

• a medical record
• the medical record

Ukrainian does not do this with separate words. Instead, definiteness is understood from:

• context
• word order
• the situation

So Довідка є в медичній картці could correspond to:

• The document is in the medical record
• A document is in the medical record

depending on context.

A learner often notices that this looks awkward because of the consonants.

A rough pronunciation guide is:

• картці ≈ kar-TSEE

The тц cluster is real: you pronounce the t and then the ts sound.

So it is not simplified to just one sound in careful speech.

If you say it slowly:

• кар-тці

then speed it up, it becomes more natural.

It sounds fairly neutral, and with є it can lean a little more formal or written.

Especially in administrative or medical contexts, this style is very normal.

A more conversational version might simply omit є:

• Довідка в медичній картці.

But the original sentence is completely natural and correct.