PDO Medical examinations specification SP1230

Petroleum Development Oman LLCRevision: 3.0Effective: 16 Apr 2007bowel habits17. Blood in stools(motions)18. Marked change inweight19. Varicose veins20. Lump inbreast/armpit21. CancerHow much tobacco each day?FAMILY HISTORY39. Tropical disease40. Fear of heightsHAVE YOU EVER BEEN:-41. Rejected foremployment orinsurance for medicalreasonsAverage daily alcoholconsumptionDiabetes Tuberculosis Epilepsy Asthma EczemaHeart disease High blood pressure Stroke Blood Disease CancerPLEASE READ THE FOLLOWING STATEMENT AND IF YOU AGREE KINDLY SIGN IT:-I declared these statements to be true to the best of my knowledge and belief and I agree that the result of thismedical examination in general terms may be revealed to the Company if required, and the details sent to my owndoctor if this is considered necessary by the examining medical officer.Date:Signature of Applicant:Page 77 SP-1230 : Specification for Medical Examination, Treatment & Facilities Printed 25-Sep-08The controlled version of this CMF Document resides online in Livelink®. Printed copies are UNCONTROLLED.