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The ornamental design for a surgical template for distal extension, as shown and described.
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FIG. 1 is a rear perspective view of a surgical template for distal extension embodying my design;
FIG. 2 is a front perspective view thereof;
FIG. 3 is a front view of FIG. 2, the rear view being a mirror image of the front view;
FIG. 4 is a right side elevational view thereof, the left side elevational view being a mirror image of the right side elevational view;
FIG. 5 is a top plan view thereof; and,
FIG. 6 is a bottom plan view thereof.
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