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  • Certificate of Health

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    Rozaliamayasari
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    Jibril Brilliant Smith, a 16-year-old male from Sidoarjo, East Java, Indonesia, was examined and found to be in good health, as documented in his Certificate of Health for participation in the Shotokan Karate Open International Competition and Subaru Cup 2018. The certificate provides his personal details, physical measurements, blood pressure, blood type, and confirmation of no color blindness.

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    Jibril Brilliant Smith, a 16-year-old male from Sidoarjo, East Java, Indonesia, was examined and found to be in good health, as documented in his Certificate of Health for participation in the Shotokan Karate Open International Competition and Subaru Cup 2018. The certificate provides his personal details, physical measurements, blood pressure, blood type, and confirmation of no color blindness.

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    13 Ansichten1 Seite

    Certificate of Health

    Hochgeladen von

    Rozaliamayasari
    Jibril Brilliant Smith, a 16-year-old male from Sidoarjo, East Java, Indonesia, was examined and found to be in good health, as documented in his Certificate of Health for participation in the Shotokan Karate Open International Competition and Subaru Cup 2018. The certificate provides his personal details, physical measurements, blood pressure, blood type, and confirmation of no color blindness.

    Copyright:

    © All Rights Reserved
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    von 1

    CERTIFICATE OF HEALTH

    No: 065/ DIR/ RSI-SH/ I/ 2018

    The undersigned explains that,


    Name : Jibril Brilliant Smith
    Age : 16 Years Old
    Gender : Male
    Address : Sidokepung RT.15 RW.03 Buduran-Sidoarjo-
    East Java - Indonesia 61252
    Height : 163 cm
    Weight : 68 kg
    Blood Pressure : 110 / 70 mmHg
    Blood type : AB
    Color blindness : No
    It has been examined carefully and expressed healthy.
    This Certificate of health is used for : The Shotokan Karate Open International
    Competition and Subaru Cup 2018.

    Sidoarjo, 13rd January 2018


    Medical Director

    dr. H. Sulistio

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