Get DK S-803E-2000
Hernia Hearing (see V1) Reflexes Spinal column Without hearing aid Alb. Urine Sugar Special remarks (if any) Normal………... without correction Normal speech Yes Normal speech at Otoscopy a distance of 4 m Right ear Left ear With hearing aid Unfit for Fit for look-out look-out duty duty Is the examined in your opinion fit for duty?………………………………………. If “no”, please state the reason Result: Unfit for look-out duty and engine-room duty No Yes If fi.
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