Doctor's
Hospital Nakhon
Sub. In city. Muang. Phanom (0-4251-1422)
................................. Date .................
I GG's New Jewelry Confederation, MD. Medical professional license number. The 26135
has examined ............................................. .............................. on ................. ................................. appear
............... .................................................. ...... not a handicap You can not perform his duties,
not incompetence or mental infirmity and disease free, these
1) tuberculosis in HIV infection
2) filariasis in the signs offensive to society
3) disease drug. Stick to blame
4) Alcoholism
5) or contagious diseases. Chronic disease or severe the symptoms become apparent and a barrier
to operational duties as CSC
6) ...................... ..... (if necessary to detect the disease associated with the operation of the receiver to
detect, identify in this Article) ..................... .................................................. .................................................. ............... Opinion And recommendations of doctors Completely healthy good sign ............................................. .......................... (GG's New Jewelry Confederation, MD. ) The doctor who examined the body Note (1) is a registered, licensed physician medical professional (2) provides that a perfect body, one medical certificate is valid for one month from the date of examination me .... .................................................. ........................ has been examined by the GG. The New Jewelry Confederation, MD. Real signed ................................................ .......................... (....................... .................................................. ............) , who has been investigating the identity card number .......................... ........................................
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