Oil Tanker Crew Illness Incident Report
Report Date
Vessel Name
IMO Number
Reported By (Name & Rank)
Date & Time of Incident
Crew Member Name
Rank/Position
Nationality
Age
Sex
Male
Female
Other
Details of Illness / Symptoms
Location of Incident (e.g., Onboard location, at sea, in port)
Actions Taken (First Aid, Medical Treatment, etc.)
If Medical Advice Sought (Doctor, Telemedicine, Hospital)
Current Status of Crew Member
Additional Remarks