ICD
	      INTERNATIONAL  COURSE  DEPARTMENT
                             SLOVAK REPUBLIC	

To:   	……………………………………………….
From:	 ………………………………………………
             ………………………………………………
Date:	………………………

  MEDICAL CERTIFICATE

…………………….………………………………………………………………………….
                                                        RANK AND FULL NAME

This is to certify that the above named student attending the Course is medically, physically and dentally fit and is free from infectious diseases.     

His/her* hearing and eyesight are normal to our Armed Forces standards, including use of corrective lenses and he/she* does not suffer any impediments, which might adversely affect his/her* performance in the course.

Currently He/she* is/is not under medication.   If he/she* is under medication, please give details and remark that he/she* is authorised to be in possession of the following medication or drugs:

Details…………………………………………………………………………………………
…………………………………………………………………………………………………

Vaccination:	
								Validity
Tetanus						           	............
Diphtheria							............
Hepatitis A,B							............
Meningococcal meningitis					............	
Tick-borne encephalitis					............
 
All vaccinations must be proved by International Certificate of Vaccination (Yellow Card).

Signed………………………………. (By a Doctor/Medical Officer)                                        STAMP

Name………………………..   Rank………………………..

Appointment…………………………………………………

STUDENTS WILL NOT BE ACCEPTED WITHOUT THIS FORM

*underline the applicable