The required minimum information on a STCW medical certificate shall be in accordance with STCW Section A-1/9.7
7 The medical certificate provided for in regulation I/9, paragraph 3 shall include the following information as a minimum:
.1 Authorizing authority and the requirements under which the document is issued
.2 Seafarer information
.2.1 Name: (Last, first, middle)
.2.2 Date of birth: (day/month/year)
.2.3 Gender: (Male/Female)
.2.4 Nationality
.3 Declaration of the recognized medical practitioner
.3.1 Confirmation that identification documents were checked at the point of examination: Y/N
.3.2 Hearing meets the standards in section A-I/9: Y/N
.3.3 Unaided hearing satisfactory? Y/N
.3.4 Visual acuity meets standards in section A-I/9? Y/N
.3.5 Colour vision * meets standards in section A-I/9? Y/N
__________
* Note: Colour vision assessment only needs to be conducted every six years.
.3.5.1 Date of last colour vision test.
.3.6 Fit for look-out duties? Y/N
.3.7 No limitations or restrictions on fitness? Y/N
If “N”, specify limitations or restrictions.
.3.8 Is the seafarer free from any medical condition likely to be aggravated by service at sea or to render the seafarer unfit for such service or to endanger the health of other persons on board?: Y/N
.3.9 Date of examination: (day/month/year)
.3.10 Expiry date of certificate: (day/month/year)
.4 Details of the issuing authority
.4.1 Official stamp (including name) of the issuing authority
.4.2 Signature of the authorized person
.5 Seafarer’s signature – confirming that the seafarer has been informed of the content of the certificate and of the right to a review in accordance with paragraph 6 of section A‑I/9