----------+---------------------------------------------------+--------- | _Date of Medical Examination and_ | | _Signature of Medical Officer._ | Year +------------+-----------+--------------+-----------+ and | Date of | | Date of | |Remarks. Month. | inspection | Signature | inspection | Signature | | in the 1st | of Medical| in the second| of Medical| | half month.| Officer. | half month. | Officer. | ----------+------------+-----------+--------------+-----------+--------- 18~92~ | | | | | | | | ~15./92~ | | January | ~1st~ | | ~23./92~ | | | | | ~27 /92~ | | | | | | | February | ~1st~ | ~initial~ | ~15 /92~ | ~initial~ | | | | | | | | | | | March | | | | | | | | | | | | | | | April | | | | | | | | | | | | | | | May | | | | | | | | | | | | | | | June | | | | | | | | | | | | | | | July | | | | | | | | | | | | | | | August | | | | | | | | | | | | | | | September | | | | | | | | | | | | | | | October | | | | | | | | | | | | | | | November | | | | | | | | | | | | | | | December | | | | |