The paper wasn’t photoshopped.
It shows, in ink, the date stampping from the reverse side.
No forger would forge the ink dating but forget the more important ink signature block.
The document really comes from the Department of Health.
The path of its creation is the issue.
Which can be simply resolved by Obama’s people letting others take a hands-on look at it.
It most certainly was photoshopped. Otherwise they Obama webiste version would match the KOS website version.