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Dentity seen Y/N B Medical History Review: The applicant s medical history remains unchanged since the last LAPL medical certificate issue C Examination report: (Only to be completed at initial, if 50 years or if examination is clinically indicated, otherwise omit) Height Examination category Initial Revalidation /Renewal Weight cm Uncorrected Blood Pressure / kg Clinical examination: Check each item Ears, drums, eardrum motility Eyes including visual fields (to confront.

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