Deck Cadet Pre-Sea Medical Certification
Personal Information
Name of Candidate:
Date of Birth:
Nationality:
Gender:
Male
Female
Other
Identity Document No.:
Medical Examination
Height (cm):
Weight (kg):
Blood Pressure:
Vision (Right/Left):
Color Vision:
Hearing:
Any physical deformity:
Other remarks:
Certification
This is to certify that the above-named candidate has been medically examined and found:
Fit for Pre-Sea Training
Unfit for Pre-Sea Training
Fit with limitations
If fit with limitations, please specify:
Date of Examination:
Place of Examination:
Signature of Candidate
Signature & Seal of Medical Officer