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1、境外人员体格检查记录验证证明中华人民共和国出入境检验检疫ENTRY-EXIT INSPECTION AND QUARANTINETHE PEOPLES REPUBLIC OF CHINA境外人员体格检查记录验证证明样本姓/ Surname性别/ Sex国籍/ NationalityCERTIFICATE OF VERIFICATION(FOR PHYSICAL EXAMINATION RECORD FOR FOREIGNERS OR OVERSEAS CHINESE)名 / Given names出生日期/ Date of birth证件号码/ Passport or ID No.编号No.照
2、片(2时)职业/ Occupation职业/ Occupation公司/ 学校 / 其它 Company / school / othersphoto(2H)加盖钢印Stamp通讯地址中国/ Mailing address (China)电话号码中国/ Telephone number (China)兹证明此申请人所持健康检查记录，经过验证，符合要求。本证明自签发之日起，有效期为六个月。This is to certify that the health examination record held by this applicant accords with the requirement as a result of verification.This certificate is valid for six months from the date of issue.医师姓名/ Name of Physician医师签名, Signature of Physician签发 H 期/ Date of issue签发 H 期/ Date of issue要 发地点 / Place of issue印章Official Stamp5-7(2018.4.20) 2