GM1 MED.C.030(b) Cabin crew medical report
ED Decision 2019/002/R
GENERAL
The format of the cabin crew medical report may be as shown in the example below, with the size of each sheet being 1/8 of A4.
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State of issue CABIN CREW MEDICAL REPORT |
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I The State where the aero-medical assessment is conducted: III Cabin crew attestation reference number: IV Last and first name: XIV Date of birth (dd/mm/yyyy): VI Nationality: VII Signature of CCA applicant/holder: |
II Aero-medical assessment result (fit/unfit): Expiry date of the previous cabin crew medical report (dd/mm/yyyy): Date of aero-medical assessment (dd/mm/yyyy): X Date of issue* (dd/mm/yyyy): X Signature of the AeMC, AME or OHMP: XI Seal or stamp of the AeMC, AME or OHMP: |
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* Date of issue is the date the Cabin Crew Medical Report is issued and signed.
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XII Limitation(s), if applicable: Code: Description: Code: Description: Code: Description: |
IX Expiry date of this medical report (dd/mm/yyyy): |
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