Medical Certificate FMS MEDICAL CLINIC AST ENTRANCE LINKETKAI MALL LAPASAN CAGAYAN DE ORO CITY Teleince No |Athration 09978103786 RIO-21-002053 Fam Ades JULINAENDERIZ@VAOO.COM Dermalog Internal Reference No. Print Date: 1016/2023 2:17:38 PM MEJED4510165211291 PERNO : R10100701101623065 APPLICANT'S INFORMATION Name MEJIA, EDUARDO AVILA Date of Binh tnenis4s Nites [BUENA ORO MACASANDIG CDO CITY ‘Maria Sas MARRIED Ae " Conder MALE Natioaity Filpine GENERAL INFORMATION FyeCokor | lade Blow Type oO Gone Posie Normal Spey eight ws Contagious ise Normal Speci Weigh 7” Upper Extremities Let: Norma Right Norma Bed Presre 2090 Lower Extemities Let Normal Rig: Normal VISUAL TEST SpeleBaley Lovie Leh Bye + 20160 Right Bye: 2060 Color Blind Tet ss ‘With Comective Lens Let Bye: Ne Right Bye: No Pyeexaminationlare Blind Leh Bye: Ne Righttye: No HEARING TEST Anko LeA Bar: Nore Right Ear Normal Good Hearing METABOLIC AND NEUROLOGICAL DISORDERS Diabees Ne Epepey No Spit Shp Apnea No sci Agarosive, Manis of Depressive Disorder Ne Spi (Oder metal condition or impairment No Sei ‘wich may aft ability to dive sey Isit unde proper contol td msdn ASSESSMENT Reason Recommenistion + Driving FITTODRIVE ots CONDITIONS ers bmervaions WEAR CORRECTIVE LENSES Ii] V-STAR MEDICAL SYSTEM REMARKS Otros DRIVERS LICENSE NO. : K0289041127 | NON PROFESSIONAL | RENEWAL | Physician: LERIAS, EVANSUENDA CANONIGO | PRCNo : 0038586 | PTRNo : 556i Date examined : 10/16/2023 Valid watil: 12/15/2023 : an SE Z