medical request format
DESCRIPTION
Medical formTRANSCRIPT
MEDICAL REQUEST
Dr. TIMING:
PARAMOUNT CLINIC
A/c. TORM SHIPPING
Date:
Kindly examine Mr. AMTOJ SINGH Passport No.
Contact Detail 9582850236 CDC NO
Date of Birth 12.11.1990 Category
1. Medical Examination For :
A. ILO Medical Ship
B. DANISH MEDICAL(1 years validity for both ILO & Danish)
Reg. No. C. SINGAPORE MEDICAL
Reg. No.
D. MARSHALL ISLAND MEDICAL
E. Above 40 yrs to do their ECG & STRESS TEST
F. Drug & Alcohol Test File. No.
2. Cholera innoculation and authentication of international certificates of vaccination for cholera.
Kindly send us the bills directly to Mumbai office.
Yours sincerely,
MS AASTHA VIJ 2266407364
MEDICAL REQUEST
21ST JUNE 2014
G2972702
MUM160302
3RD OFFICER
TORM GARONNE
2. Cholera innoculation and authentication of international certificates of vaccination for cholera.