HONG KONG GOVERNMENT
APPLICATION FOR MEDICAL EXAMINATION
airman;
Medical Examination Board
Canton Rd. Govt. Offices, 7th fl.,
14.10.91
Date of appointment booked:
393, Canton Road,
Kowloon.
RECEIVED
1214
Please arrange for medical amination of
2 2 OCT 1991 SUPREME CONST LA B
Time of appointment booked: 10:45
Previous M.E.B. No.
(a) employment }
present rank if serving
The Honour Mr. Justice KEMPSTER
for fitness for:
name
with-effect--from-
post
оп
date
term of employment
a
៣
*(b) retentier /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.
in
Judiciary
Department
on
2.1.82
date
Judge of the High Court
post
"He/she is at present
serving on *temporary/probation/permanent/agreement terms.
Date of birth:
21.6.23
......
*HK Identity Card/Passport No. XD 828585
*Copies of previous medical reports and siek leave statement-extre sed from his/her past five-years-siek-leave —record-are-attached/No, sick leave taken during the immediate preceeding five years.
2.10.91
Date
Dept.
Judiciary
(Ms. Jennifer KWONG) Tel. 825 4208. Signature for Registrar, Supreme Court
MEDICAL EXAMINATION BOARD'S REPORT
M.E.B. No.
721831
The above-named has been medically examined by the Board and found physically
*(a) FIT for the purpose shown above 'subject to wearing suitable spectacles/contact lenses. *His/her present
'spectacles/contact-lenses "are/are-not-suitable.
*(b) UNFIT,the diagnosis or suspected diagnosis being..
Special remarks/recommendations:
2 1 OCT 1991
Date
(
Dr. J 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.