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.
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: |
2 |
3 |
* Date of issue is the date the Cabin Crew Medical Report is issued and signed.
XII Limitation(s), if applicable: Code: Description:
Code: Description:
Code: Description: |
IX Expiry date of this medical report (dd/mm/yyyy): |
4 |
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