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Seafarer Medical Certificate
Seafarer Medical Certificate
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LANTERN/cl~dRMc;pO<::>:Ji'>O
RIGHT EYE
20/20 - Yellow 8300>:J<::'O LEFT EAR/ 8::,t:Job:Jfo tj';'.'.JMO
D:iMX3:Jfo m3::,<::'.'o Red VOO>:J<::'0
LEFT EYE Green avs:i6a 6M
20/20 -
8:iMob:Jfo m3::,<::'.'o Blue <::''JM:X.O
BLOOD TYPE A(II)RH+ EYE COLOR HEIGHT(cm) 188
HAZEL
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WEIGHT (kg) Body Mass Index
80 22.6
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Visual acuity meets standards in STCW Code, Section A-1/9?
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0Yes/q:JO::,b 0
Unaided / o:r.:io:iM~:Ji'>:J<::>n o,3::,<::100>
ll1'l:i6co.:>Mc'lni'>b? Aided / cbJ!'lM:)()OM:Ji'>:J<::>O b:io•:·P<::>:JOOO>
Color vision meets the standards in STCW Code, Section A-I/9? @Yes/q:io~b 14/03/2023
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llc'l.:>6co::,Mc'lni'>ll? Dat~oflai.tcolorvisiontest / ~ ~ ~ ~ " >
Fit for Look-Out duties? cl:J-::Jd<::>o~ ~V~M8!'l!'lb b~fo30 0~oo!'l 8:Joi3~<::'8-::JM:J!'l<'.>~ (vo6il~tJ~M:Ji'>:J<::>n)?
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0 Yes/ c;po~b 0No/ .'.>M.'.>
Is the seafarer free from any disease likely to be aggravated by service at sea or to render the seafarer
unfit for such service or to endanger the health and safety of other person~ on·board? 0Yes/,;,pO.">b 0No/.'.>fo
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\1f No. m•k• explanation on back p•g•/ ::J->M<J"l'llomo J>b:,bolJ oo8m~>oo 0».iomom 7,>68>0>1'.)o&> ::JJ,>6> il:JOMl!,l'llO)
If yes, please indicate the name of medications. 80j0JCJCJJOOJ 8:Jc;t>OJ."l8:J6oo (w:iwo5omo 3:ibjbob clo8mb303:iclo)