| ® KLINI MEDICAL FITNESS CERTIFICATE MEDICAL REPORT ALL ME Joccupatinal Health Center ‘issued in accordance with (This document wae adopted from Sainem company and used only for Saipern ‘elentisubcontractor) ILA MEDICAL FITNESS CERTIFICATE il & Gas UK Guidelines, Saipem Corporate Standards OPR-COR-MR-HLT-OO1-E, STD-COR-HLTOLI-OOI-L IMO and STCW Guidelines on medical examination oS Fit co Unfit Specify prescriptions and/or restrictions Full name (ir bck ettess) Date of Birth Occupation WMuarsertein 01 1996 Fikter Structure 22 Auv Wwd3 ‘This Health Certificate is valid until: a offshorewonshore » Fit with prescriptions and/or restrictions a permanent © temporary for months © permanent f temporary for months ‘Applicant's signature in the Doctor's presence Place Bay, Month, Year Doctor's stamp and signature TG.BALATKARIMUN — 23 AUG 2022 Employer must provide the personal protective equipment specific to the activity