What do attempts at documentary standardization in a clinic in Maputo, Mozambique, reveal about transnational medical governance? By following medical and bureaucratic practices in an NGO-supported public clinic, I illustrate how documentary practices enact and complicate medical authority in Mozambique. In efforts toward standardization, medical documents are made multiple, simultaneously articulating a range of ethical, bureaucratic, and knowledge-producing activities. Concurrently, medical authority itself is multiplied, as a plurality of agencies and institutions come to intervene in and on practices of documentation, measurement, knowledge production, and care in the clinic. Anthropologists have shown how pluralities of medical care present both predicaments and opportunities for patients and healers; I extend these insights to the material life of postcolonial and transnational medical governance, suggesting that governmental and medical multiplication through the document form presents opportunities as well as challenges for the patients, local health workers, and staff of international organizations who navigate this varied documentary terrain.