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PETROCHINA INTERNATIONAL JABUNG LTD

HSSE DEPARTMENT – HEALTH SECTION


HEALTH EXAMINATION & FITNESS FOR TASK

Appendix 12.13 Hasil Verifikasi Dokumen Kesehatan dan/atau Pemeriksaan Kesehatan


PCID/J/F- Verification Results Health Document and or Health Examination
8/HSE/EHSMS/4.5.1/07

Tanggal/ Date 06 Februari 2023 Klinik / Clinic Jakarta

Dept. Pengguna / Dept. User Drilling Dept. No.Surat / Letter 03/II/MCU/HSSE/2023

Age Duration
No. Name (Year) Company (Days) Result Health Document / Note
Obese
Myopia
Suggestive ischemic response
Consult with ophthalmologist regaring
1 Nurjasa 55 BDSI - PMK 365 Currently Unfit
myopia
Consult with cardiologist for CT coronary
arteriography
Get Typhoid vaccination
2 Debi Irwandi 42 BDSI - PMK 365 Fit
Surya Fresna
3 26 BDSI - PMK 365 Fit
Yudha
Hypercholesterolemia
4 Buhari 59 BDSI - PMK 365 Fit with note
Elevated LFT
IRBBB
5 Ahmad Ridwan 26 BDSI - PMK 365 Fit with note
Prediabetic
Elevated LFT
6 Reza Anggara 32 BDSI 365 Fit with note
Sinus bradycardia
Fit with Hypercholesterolemia
7 Sisdiarto 59 GWDC 365
recommendation Take antihypercholesterolemia regularly
Hypercholesterolemia
Urbanus
8 56 ENECAL 365 Fit with note RBBB
Takarianta
Susp NIHL
Hyperglyceridemia
Fit with
9 Jia Donglai 44 ENECAL 365 Myopia
recommendation
Consider to change the correction glasses
Armien Tri GBU
10 39 365 PENDING NO MCU DOCUMENT
Iskandar Dewatering
GBU
11 Vidianto 28 365 PENDING NO MCU DOCUMENT
Dewatering

TandaTangan / Signature
Nama / Name : dr. Suci Hidha Widiani

No. Surat Izin / License No.: 16B.15A/31.74.02.1003.01.052.K.1.a.b/3/


-1.779.3/e/2021
Dokter Perusahaan
Company Doctor

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