Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

6ME form for helpers

Please examine the helper and submit the 6ME Medical Exam Due Date:
results online within 2 weeks at: mom.gov.sg 16 Aug 2022
/submit-results-clinic

Helper's name NAN SAN KHAM

Helper's FIN M3014392W

To: Examining Doctor


The six-monthly medical examination (6ME) is a statutory requirement under the Employment of Foreign Manpower Act.
The employer or their representative must not be present while you conduct the tests below.
Please submit the results online within 2 weeks from the date the helper visited your clinic. Otherwise, the helper's Work
Permit may be revoked.

To be completed by Examining Doctor

Helper's weight (in kg) Height (in cm)

Signs of suspicious and unexplained injury: Date helper visited clinic (DD-MM-YYYY)
Yes / No

Medical tests Negative / Non-Reactive Positive / Reactive

Pregnancy

Syphilis test

Details of Examining Doctor

Name Medical Registration (MCR) number

⚠ IMPORTANT

If you suspect that the helper is being abused, call the MOM Helpline for helpers (1800 339 5505). If she is in
imminent danger, call the Police (999) immediately.

Ministry of Manpower Work Pass Division


Web https://www.mom.gov.sg Contact us https://www.mom.gov.sg/contact Page 1 of 1

You might also like