GLOBEX INCIDENT REPORT
March 7th 2035
ER- Company Documents and Files
Copy 23 of 31- Medical Examination Report
Medical Examination Report
FOR NEW APPLICANTS
The Medical Examination may be conducted in any Globex operational center by any registered Health Personnel (HP). Applicants who are restricted to off-facility services may have their medical examination and SES test conducted in their places of residence. If SES testing is conducted in a Globex operational center, it may be carried out with either rapid or ELISA tests.
FOR RENEWAL APPLICANTS
The Medical Examination MUST be conducted in a Globex operational center by any registered HP. SES testing may be conducted with either rapid or ELISA tests.
NOTES FOR ALL
This Medical Examination Report is to be completed by a registered doctor and returned to the examinee. The original copy of the laboratory report for SES and the C-Scan report must be attached to this Medical Examination Report only if the medical examination and testing is carried out off-facility.
The laboratory report for SES and the C-Scan report submitted to the Security And Safety Authority should be within THREE MONTHS from the date of the issue of the report.
1- Personal Information
Name: [REDACTED] Ruffio
Sex: Male
Date of Birth: [REDACTED]
Nationality: American
MID #: [REDACTED]
Occupation: Technician
Address: PHC-[REDACTED]
2- Medical Examination
I certify that the above-named has undergone a C-Scan and the result of his/her C-Scan is as indicated (with a [Y/N])>
1
Symptoms (C-Scan*)
Did the patient display any or all of the following symptoms during the procedure?
Rapid eye movement _ [REDACTED]
Aggressive behavior_ Y
Seizure_ [REDACTED]
Paranoia_ Y
Nose bleed_ Y
Blindness_ [REDACTED]
Hallucinations_ Y
[*Pregnant Women are exempt from Conscious C-Scan]
I certify that I have tested the above-named and the result of his/her SES test is as indicated below (with a [Y/N])>
2
SES:
Positive_ N/A
Negative/Non-reactive_ N/A
Name of Examining Doctor: Amelia Beaumont
Signature (Scanned): AMELIA BEAUMONT
Clinic's Room Number: Medroom-501
Clinic's Personnel Supervisor: Rachel Strous
Date: 7-March-2035
IFC Number: [REDACTED]
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