Undertaking letter - Medical Awarenesss

MINISTRY OF
MANPOWER
AH SINGAPUR

Use this form to undertake that you are aware

of your worker's medical condition
UNDERTAKING BY EMPLOYER

lam aware that MEENATCHISUNDARAM KARTHIK (worker's name),

G2486169X 23/06/2023 (date of application), who is employed as a

(FIN)

CONSTRUCTION WORKER (worker's occupation) has

blood glucose and blood lipids abnormal. (medical condition or abnormal finding(s) indicated in

the full medical examination form) and Ideclare that Istill wish to employ this worker.

In addition, if my worker is required to have a Primary Care Plan (PCP), I will:

Send the worker for folloW-up consultation at the MOM Medical Centre that is managed by the
relevant Anchor Operator².
Ensure compliance to better manage the worker's medical condition.

Name of employer / authorised Organisation's name:

representative:

Designation:

NRIC no. IFIN: Signature:

Date
(ddimmyyv)
A IMPORTANT
Workers found to have "abnormal" colour vision do not need treatment but cannot work in
jobs that involve electrical works and driving.

2 For workers who are required to be enrolled as a member of the PCP, please inform them
to bring along the doctor's referral memo for their follow-up consultation at the MOM
Medical Centre that is managed by the relevant Anchor Operator listed on
go.gov.sg/mommedicalcentres, For more details on the PCP, please visit
www.mom.gov.sg/primary-healthcare-system.

Ministry of
htpsAower Work Pass Division
Web .gov.sg Contact Us htps:/Awww.mom.gov.so/contadt Page 1of 1
 Work Pass Division
18 Havelock Road
MINISTRY OF
Singapore 059764
www.mom.gov.sg MANPOWER

Name of Worker: MEENATCHISUNDARAM KARTHIK Passport No.: W9051304

Part IV Certification from the Doctor

Tcertity thatIhave examined the worker for the clinical examinations / tests in Part ll and found that this person is "Fit / i for employment in
the above-stated occupation.

Dr Winston Lee
Name of Doctor: M66153H
(in BLOCK Letter) Signature of Doctor:
Clinic Address: Fullerton Health (MWOC @Sengkang West) Date: 14 Jul 2023

20A Seletar West Road 1 Singapore 798991 Telephone Number:

*Delete where inapplicable

Vetting Dr: Dr. Kimberly
MCR M63802A
Doctors to Note:
Please return the completed medical examination form to the employer / employment agent promptly, so that they can get the Work Permit issued.

WPCM 015-MWOc| The information is updated on 20 July 2022

 SHANAH MEDICAL CLINIC PTE LTD
BIk 633 Veerasamy Road #01-120
SINGAPORE 200633
Tel: 62922 777/ Fax: 62924177
Company Reg No: 201631067H

Date:29th July 2023

Work Permit Department

Ministry of Manpower
Singapore

Re: MEENATCHISUNDARAM KARTHIK

G2486169X

The above was found to have diabetes mellitus and hyperlipidemia at an

MOM Onboarding Centre.
He has no prior history of diabetes mellitus. Physical examination did not
reveal any significant findings
He was prescribed medication for his diabetes mellitus and
hyperlipidemia. He was advised on healthy lifestyle changes and to continue his
medication.

He is medically fit for work asa construction worker.

Thank you
Yours truly,
Shanah Medical Clinic Pte Ltd

DR. KHOO YONG HAK

Dr Khoo Yong Hak (MBBS SPORE) MCR 08220D
SHANAH MEDICAL CLWK PIE LTD
Co.Reg.No : 2016310STH
Bik 633 Veerasamy Roed #01-120
Singapors 200633
Tal:6202 2777 Fe:6292 4177