BESCHEINIGUNG DER NICHT-EIGNUNG - Deutsche Gesellschaft ...

FIRST NAME:
CERTIFICATE OF FITNESS
OFFSHORE MEDICAL CERTIFICATE
NAME: Date of Birth:
HOME ADRESS:
COMPANY NAME:
OCCUPATION:
___________________________________________________________________________
CATEGORY: A (all, supervisor) � / S (operator, specific emergency) ��
This individual has been examined in consideration of DGMM
Medical Recommendations and in my opinion is FIT to work offshore.
Examining Physician’s Name and Address:
Date of Examination: Next Examination:
Signature (Physician)
Signature (examined person)
Remarks:
Ärztliche Eignungsuntersuchungen bei Arbeitnehmern
36 auf Offshore-Windenergieanlagen und Plattformen DGMM e.V.