ATCO.AR.F.005 Medical certificate

The medical certificate shall conform to the following specifications:

(a)Content:

(1)State in which the ATCO licence has been issued or applied for (I);

(2)Class of medical certificate (II);

(3)Certificate number commencing with the UN country code of the state in which the ATCO licence has been issued or applied for and followed by a code of numbers and/or letters in Arabic numerals and Latin script (III);

(4)Name of the holder (IV);

(5)Nationality of the holder (VI);

(6)Date of birth of the holder (XIV);

(7)Signature of the holder (VII);

(8)Limitation(s) (XIII);

(9)Expiry date of the class 3 medical certificate (IX);

(10)Date of examination;

(11)Date of last electrocardiogram;

(12)Date of last audiogram;

(13)Date of issue and signature of AME or medical assessor that issued the medical certificate (X);

(14)Seal or stamp.

(b)Material: The paper or other material used shall prevent or readily show any alterations or erasures. Any entries or deletions to the form shall be clearly authorised by the competent authority.

(c)Language: Medical certificates shall be written in the national language(s) and in English and in such a language that the competent authority deems appropriate.

(d)All dates on the medical certificate shall be written in a dd/mm/yyyy format.