airman,
HONG KONG GOVERNMENT
APE
TION FOR MEDICAL EXAMINATION
18.11.91
2 2 NOV 1931
RECEIVED
Date of appointment booked:
Time of appointment booked:
8:45 a.m.
Previous M.E.B. No.
Medical Examination Board,
Canton Rd. Govt. Offices, 7th fl,
393, Canton Road,
(102
Kowloon.
Please arrɛ age for medical examination of The Honourable Mr. Justice FUAD Kutlu Takin
Justice of Appeal
for fitness for:
name
present rank if serving (a) -employment-as-
post
with effect from-
date
*(b)
-OA.
term of employment
retention/extension-of-service-till-
*(c) the following purpose:
Transfer to permanent and pensionable establishment.
in the case of Study Leave, date of commencement, place and duration of course must be clearly stated
The applicant is at present in Government Service being first appointed as. Judge of High Court.
post
in
Judiciary
Department
on
4.9.80
serving on temperary/probation/permanent/agreement terms.
23.4.26
Date of birth:
............
date
*He/she is at present
*HK Identity Card/Passport No.
XD 686848
*Copies of previous medical reports and sick leave statement extracted from his/her past five years' sick leave record are attached/No-sick leave taken during the immediate preceeding-five years
Date
24 OCT 1991
Dept.
Judiciary
825 4208
Tel..
(Ms. Jennifer KWONG Signature for Registrar, Supreme Court
А
F16881
MEDICAL EXAMINATION BOARD'S REPORT
The above-named has been medically examined by the Board and found physically
M.E.B. No.
(a) FIT for the purpose shown above "subject to wearing suitable spectacles/contact lenses. "His/her present-
'spectacles/contact lenses arayara not suitable.
(b) UNFIT, the diagnosis or suspected diagnosis being ———,
Special remarks/recommendations:
2 1 NOV 1991
Date
(
DY. I KAN Pik-ha
)
Chairman, Medical Examination Board.
Notes for Depts. This form should be taken by applicant to M.E.B. on date of appointment booked. Applicants must be advised that they should produce for inspection at M.E.B. their identity cards and for assessment of aided vision, their spectacles, if worn.
'Delete whichever NOT applicable.
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