MEDILA «Tvie document was adopted from Saipem company and used ont for Saipan ‘cient/subcontractor ) in KLINIK | MEDICAL FITNESS CERTIFICATE MEDICAL REPORT \ ‘Occupational Health ‘issued in accordance with Nurla sort ae | MEDICAL FITNESS CERTIFICATE fi & Gas Uk Guldetnes, Ssipem Corporate Standards OPF-COR-HR-HLT 008+, STO-CORMETGUOS Imo and STEW Guidelines on medical examination Full name (in bicck eter) Date of Birth Occupation ] 3 -u-G8b. {ueiier | ve o Fit with presci | Unfit Specify preserions and/or restrictions This Health Certificate is valid until: 21 AUG 2023 1 offshore orshore iptions and/or restrictions 3 permanent © temporary for months... Gi permanent a temporary for months. FIT-TO WORK(. Ee ‘Applicant's signature in the Doctor's presence Day, Month, Year 2.2 AUG 2022 Employer must provide the personal protective equipment specific to the activity