Kir Asing (Freddy) +labor

Nomor : 0204 / UKP / PHO / VIII / 2006
PSYSICAL EXAMINATION REPORT
Last Name of Applicant : MR. QIAO RONGMEI / First Name : -

Middle-Initial : - / Country : PR. CHINE
Date of Birth : 1964.09.01 / Place of Birth : LIAONING
SEX : Male
MEDICAL EXAMINATION
Height : 170 cm / Weight : 72 kg / Blood Pressure : 120 / 80 mmHg

Pulse : 68 x / mnt / Respiration : 16 x / mnt / General Appearance : Normal
VISION HEARING
Without Glasses : NORMAL / Right Ear : NORMAL

With Glasses : - / Left Ear : NORMAL
COLOR TEST TYPE
Book : V Lantern : - / Check if Color Test Is Normal :

/ Jellow : + / Red : + / Green : + / Blue : +
HEAD and NECK : NORMAL / HEART (Cardio Vascular) : NORMAL

LUNGS : NORMAL / SPEECH : NORMAl
EXTREMITAS
Upper : NORMAL / Lower : NORMAL
EXAMINATION FOR DUTY AS : A.B
This is to certify that a physical examination was given to : MR. QIAO RONGMEI
He is found to be Fit for DUTY and NOT INDICATE WITH THE INFECTIOUS DESEASE.
This Certificate is valid for one years from date of issue.
Name and Degree Of Physician : KRIPTI HARTINI, MD
Address : PORT HEALTH OFFICE OF TANJUNG PRIOK

Jl. Raya Pelabuhan No. 17 Jakarta Utara
Jakarta, August 24 th, 2006

Examining Physician
KRIPTI HARTINI, MD
Port Medical Officer
Nomor : 0203 / UKP / PHO / VIII / 2006
Last Name of Applicant : Mr. BI MINGJIE / First Name : -

Middle-Initial : - / Country : PR. CHINA
Date of Birth : 1964-12-18 / Place of Birth : SHANDONG
SEX : Male
MEDICAL EXAMINATION

VISION HEARING
Without Glasses : Normal / Right Ear : Normal

With Glasses : - / Left Ear : Normal
COLOR TEST TYPE

HEAD and NECK : Normal / HEART (Cardio Vascular) : Normal

LUNGS : Normal / SPEECH : Normal
EXTREMITAS
Upper : Normal / Lower : Normal
EXAMINATION FOR DUTY AS : M /M
This is to certify that a physical examination was given to : Mr. BI MINGJIE

Name and Degree Of Physician : I.NYOMAN PUTRA, MD

Jakarta, July 31 th, 2006

Examining Physician
I. NYOMAN PUTRA, MD
Nomor : 0178 / UKP / PHO / VI / 2006
Last Name of Applicant : LIU ZHAO ZHONG / First Name : -

Middle-Initial : - / Country : PRC
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : 2/O
This is to certify that a physical examination was given to : Mr. LIU ZHAO ZHONG
Name and Degree Of Physician : dr. Endriana S.L

Jakarta, June 10 th, 2006

Examining Physician
dr. Endriana S. L
Nomor : 0179 / UKP / PHO / VI / 2006
Last Name of Applicant : ZHANG YI JIN / First Name : -

Date of Birth : 28-03-1950 / Place of Birth : JIANGSU
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : R/O
This is to certify that a physical examination was given to : Mr. ZHANG YI JIN
Name and Degree Of Physician : dr. Endriana S. L

Jakarta, June 10 th, 2006

Examining Physician
dr. Endriana S. L
Nomor : 0180 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. HUANG RUI / First Name : -

Date of Birth : 13-03-1978 / Place of Birth : LIAONING
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : 3/E
This is to certify that a physical examination was given to : Mr. HUANG RUI
Name and Degree Of Physician : dr. ENDRIANA S. L

Jakarta, JUNE 10 th, 2006

Examining Physician
dr. ENDRIANA S. L
Nomor : 0181 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. ZHU DA HAI / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : 4/E
This is to certify that a physical examination was given to : Mr. ZHU DA HAI


Examining Physician
dr. ENDRIANA S. L
Nomor : 0182 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. CHEN YU LONG / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : CPO / O
This is to certify that a physical examination was given to : Mr. CHEN YU LONG


Examining Physician
dr. ENDRIANA S. L
Nomor : 0183 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. JIANG MAO HAI / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : S. G. I
This is to certify that a physical examination was given to : Mr. JIANG MAO HAI
Name and Degree Of Physician : dr. ENDRIANA. S. L


Examining Physician
dr. ENDRIANA. S. L
Nomor : 0184 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. LI LI / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : S. G . I
This is to certify that a physical examination was given to : Mr. LI LI



Examining Physician
dr. ENDRIANA S. L
Nomor : 0185 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. WANG HU / First Name : -

Date of Birth : 04-07-1969 / Place of Birth : HUBEI
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
This is to certify that a physical examination was given to : Mr. WANG HU



Examining Physician
dr. ENDRIANA S. L
Nomor : 0186 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. XU YI FENG / First Name : -

Date of Birth : 04-06-1962 / Place of Birth : SHANGHAI
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
This is to certify that a physical examination was given to : Mr. XU YI FENG



Examining Physician
dr. ENDRIANA S. L
Nomor : 0187 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. HU ZHI ZHONG / First Name : -

Date of Birth : 08-03-1983 / Place of Birth : HENAN
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
This is to certify that a physical examination was given to : Mr. HU ZHI ZHONG


Examining Physician
dr. ENDRIANA S. L
Nomor : 0188 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. HAO JIN BO / First Name : -

Date of Birth : 07-09-1964 / Place of Birth : LIAONING
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : M. G . I
This is to certify that a physical examination was given to : Mr. HAO JIN BAO


Examining Physician
dr. ENDRIANA S. L
Nomor : 0189 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. WANG MING SHUI / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : M. G . I
This is to certify that a physical examination was given to : Mr. WANG MING SHUI


Examining Physician
dr. ENDRIANA S. L
Nomor : 0190 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. ZHU PIN FA / First Name : -

Date of Birth : 01-12-1948 / Place of Birth : SHANG HAI
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE

( Mixed Color : - neg )

EXTREMITAS
EXAMINATION FOR DUTY AS : C / CK
This is to certify that a physical examination was given to : Mr. ZHU PIN FA


Examining Physician
dr. ENDRIANA S. L
Nomor : 0191 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. LI BAI HE / First Name : -

Date of Birth : 10-09-1982 / Place of Birth : GUANGDONG
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : M/B
This is to certify that a physical examination was given to : Mr. LI BAI HE



Examining Physician
dr. ENDRIANA S. L
Nomor : 0194 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. LI,GUANG YI / First Name : -

Date of Birth : 10-09-1978 / Place of Birth : LIAO NING
SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : MM1
This is to certify that a physical examination was given to : Mr. LI,GUANG YI

Name and Degree Of Physician : I NYOMAN PUTRA,MD

Jakarta, JULY 16 th, 2006

Examining Physician
I NYOMAN PUTRA,MD
78*
Nomor : 0195 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. LEI, YI N CHENG / First Name : -

SEX : Male
MEDICAL EXAMINATION
Height : 172cm / Weight : 64 kg / Blood Pressure : 120 / 80 mmHg

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : SM1
This is to certify that a physical examination was given to : Mr. LEI, YIN CHENG


Examining Physician
I NYOMAN PUTRA,MD
Nomor : 0192 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. ZHENG, DIAN YUAN / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : MSM
This is to certify that a physical examination was given to : Mr. ZHENG,DIAN YUAN


Examining Physician
I NYOMAN PUTRA,MD
Nomor : 0194 / UKP / PHO /VI / 2006
Last Name of Applicant : Mr. ZHOU YUE XING / First Name : -

SEX : Male
MEDICAL EXAMINATION

VISION HEARING

COLOR TEST TYPE


EXTREMITAS
EXAMINATION FOR DUTY AS : C/E
This is to certify that a physical examination was given to : Mr. WANG,SHUN JUN


Examining Physician
I NYOMAN PUTRA,MD

Kir Asing (Freddy) +labor

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Nomor : 0204 / UKP / PHO / VIII / 2006

PSYSICAL EXAMINATION REPORT

Last Name of Applicant : MR. QIAO RONGMEI / First Name : -

Height : 170 cm / Weight : 72 kg / Blood Pressure : 120 / 80 mmHg

Without Glasses : NORMAL / Right Ear : NORMAL

COLOR TEST TYPE

Book : V Lantern : - / Check if Color Test Is Normal :

HEAD and NECK : NORMAL / HEART (Cardio Vascular) : NORMAL

Upper : NORMAL / Lower : NORMAL

EXAMINATION FOR DUTY AS : A.B

Name and Degree Of Physician : KRIPTI HARTINI, MD

Address : PORT HEALTH OFFICE OF TANJUNG PRIOK

Jakarta, August 24 th, 2006

PSYSICAL EXAMINATION REPORT

Last Name of Applicant : Mr. BI MINGJIE / First Name : -

Height : 176 cm / Weight : 85 kg / Blood Pressure : 120 / 90 mmHg

Without Glasses : Normal / Right Ear : Normal

COLOR TEST TYPE

Book : V Lantern : - / Check if Color Test Is Normal :

HEAD and NECK : Normal / HEART (Cardio Vascular) : Normal

Upper : Normal / Lower : Normal

EXAMINATION FOR DUTY AS : M /M

This is to certify that a physical examination was given to : Mr. BI MINGJIE

Name and Degree Of Physician : I.NYOMAN PUTRA, MD

Address : PORT HEALTH OFFICE OF TANJUNG PRIOK

Jakarta, July 31 th, 2006

PSYSICAL EXAMINATION REPORT

Last Name of Applicant : LIU ZHAO ZHONG / First Name : -

Height : 171 cm / Weight : 65 kg / Blood Pressure : 110 / 70 mmHg

Without Glasses : NORMAL / Right Ear : NORMAL

COLOR TEST TYPE

Book : V Lantern : - / Check if Color Test Is Normal :

HEAD and NECK : NORMAL / HEART (Cardio Vascular) : NORMAL

Upper : NORMAL / Lower : NORMAL

EXAMINATION FOR DUTY AS : 2/O

Name and Degree Of Physician : dr. Endriana S.L

Address : PORT HEALTH OFFICE OF TANJUNG PRIOK

Jakarta, June 10 th, 2006

PSYSICAL EXAMINATION REPORT

Last Name of Applicant : ZHANG YI JIN / First Name : -

Height : 170 cm / Weight : 80 kg / Blood Pressure : 130 / 80 mmHg

Without Glasses : NORMAL / Right Ear : NORMAL

COLOR TEST TYPE

Book : V Lantern : - / Check if Color Test Is Normal :

HEAD and NECK : NORMAL / HEART (Cardio Vascular) : NORMAL

Upper : NORMAL / Lower : NORMAL

EXAMINATION FOR DUTY AS : R/O

Name and Degree Of Physician : dr. Endriana S. L

Address : PORT HEALTH OFFICE OF TANJUNG PRIOK

Jakarta, June 10 th, 2006

PSYSICAL EXAMINATION REPORT

Last Name of Applicant : Mr. HUANG RUI / First Name : -

Height : 175 cm / Weight : 74 kg / Blood Pressure : 110 / 80 mmHg

Without Glasses : Normal / Right Ear : Normal

COLOR TEST TYPE

Book : V Lantern : - / Check if Color Test Is Normal :

HEAD and NECK : Normal / HEART (Cardio Vascular) : Normal

Upper : Normal / Lower : Normal

EXAMINATION FOR DUTY AS : 3/E

Name and Degree Of Physician : dr. ENDRIANA S. L

Address : PORT HEALTH OFFICE OF TANJUNG PRIOK

Jakarta, JUNE 10 th, 2006