- •Personal medical book s Photograph eries aб
- •Information on the medical book’s owner:
- •Conclusion of the physician on the admission to work according to the results of medical examination
- •Conclusion of the physician on the admission to work according to the results of medical examination
- •Results of laboratory analyses for presence of enteric infections agents
- •Results of laboratory analyses and examination by the specialist in skin and venereal diseases
- •Results of analyses for helminthosis
- •Results of analyses for pathogenic staphylococcus
- •Notes on prophylactic vaccinations
Conclusion of the physician on the admission to work according to the results of medical examination
Date |
Physician’s conclusion |
Signature, seal |
|
Stamp: Municipal polyclinic No. 12 Examination commission of Prymorsky district of the city of Odesa Medical examination Smear No. 25 of 20.09.2006 RW No. 25 of 20.09.2006 Healthy. To be admitted for work. Head of examination commission for 1 year
|
[Signature] [Seal: Shevchuk Tetyana Volodymyrivna. Physician]
|
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No. 746297
Results of examination for tuberculosis
Date |
Specialist’s conclusion |
Signature, seal |
05.09.2004
16.09.2005
20.09.2006 |
Stamp: Lungs, heart and vessels without visible pathological changes. 93 W 8 – W
Stamp: Lungs, heart and vessels without visible pathological changes. 93 W 15 – W
Stamp: For certificates. T.B. prophylactic centre No. 2. City of Odesa. 93 W 125 – W |
[Signature]
[Signature]
[Signature] |
Page 17
Results of laboratory analyses for presence of enteric infections agents
Date |
Specialist’s conclusion |
Signature, seal |
|
Stamp: Communal institution City Polyclinic No. 14 City of Odesa Bacteriological laboratory The enteric infections agents were not defined. The reaction of hematoagglutination is negative 270 19.11.2004 271 Head of bacteriological laboratory
Stamp: Communal institution City Polyclinic No. 14 City of Odesa 385 Bacteriological laboratory The enteric infections agents were not defined. 20.11.2005 261 Head of bacteriological laboratory
Stamp: Communal institution City Polyclinic No. 14 City of Odesa Bacteriological laboratory The enteric infections agents were not defined. 20.09.2006 Head of bacteriological laboratory |
[Signature]
[Signature]
[Signature] |
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No. 746297