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FIT TO TRAVEL CERTIFICATE. Doctor Signature and Stamp



FIT TO TRAVEL CERTIFICATE

 

                                                                                        Date of Issue:
                                               

 

Name  
Date of Birth  
Nationality  
Sex  
Passport Number  
Medical Examination (As per ILO147, MLC 2006 as Amended) valid till  
Home Address  

 

Above person underwent evaluation by me. He was found asymptomatic for cough, shortness of breath, sore throat or any of the respiratory symptoms. We confirm that the patient’s specimen tested NEGATIVE/POSITIVE for COVID-19 by RT-PCR assay.

 

Date of Sample Collection for Covid RT-PCR:    

Date of Reporting of Covid RT-PCR:           

 

 

He is Physically fit for travel/work/ Sea Service.

 

Doctor Signature and Stamp

 



  

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