| | @ KLINIK ] MEDICAL FITNESS CERTIFICATE MEDICAL REPORT MED (Occupational Health Issued in accordance with (his document was adopted from Saipem company and used only for Saipern ‘clentisubcontractor ) MEDICAL FITNESS CERTIFICATE 1 & Gas UK Guidelines, Saipem Corporate Standards OPR-CORHR-H4T-001-€, STE-CORHLTCH IMO and STEW Guidelines on medical examination Full name citi ter MARUASAS PASAPIBU 3 os /igt7 Mate tPeR, Date of Birth - ‘Occupation co Unfit Specify prescriptions and/or restrictions is Health Certificate is valid until: 2 1 AUG 2023 « offshore\ygfshore Fit with presctiptions and/or restrictions 9 permanent temporery for months 3 permanent © temporary for months... FIT TO WORK ‘Applicant's signatut Place Lest - fein the Doctor's presence ay, Month, Year 1G.HALATKARIMUN =? AUG 2027 Employer must provide the personal protective equipment specific to the activity