Medical certificate
Nakhon Phanom Hospital
Muang.Nakhon Phanom (0-4251-1422)
Date.............................................................
I Krittiya Wanitjiewaphan, MD. The medical professional license number 26135.
The examination………………………………………………………… On date ………………………………………………………. appear
.................................................. ..................... Not a handicap you can not perform his duties
Not incompetence or mental infirmity and free from these diseases.
1) Tuberculosis
2) Filariasis
3) The disease of addiction is to blame.
4) Alcoholism
5) or contagious diseases Chronic diseases that asymptomatic or mild and clear of obstacles.
The performance of its duties under the CSC.
6).......... (if necessary to detect the disease associated with the operation of the receiver. Make stated in this Article)............................................................................................
The opinions and recommendations of doctors. In perfect health
Sign……………………………………………………
(Krittiya Wanitjiewaphan, MD. )
Medical examination
Note (1) a registered medical licensed medical professional.
(2) Provides that a perfect body is.
The medical certificate is valid one month from the date of the examination.
I……………………………………………………………………..Obtained from
Krittiya Wanitjiewaphan, MD. Real
Sign.............................................................
(................................................................................)
The identification number.....................................................................