1. KUWAIT OIL TANKER со. S.A.K.
CREW REPORT FORM
Name: j!t:.и..t?I1I с.Е.!.(((!t! .
. IU /~/ .' - '/...J '(. '1
Vessel: ff.(... c,.. ?.I:v..?-i.I (..I г..I:i .
/'f
CR.-3
,- '.~.- /' А::!
Rank: .. /::.i ../../..C: С.О.С. No , _ .
Period from ....;:,.,z.....(!..'l, ..У..,г..'о ...2...?-;q_.r., ?...f.
Posscssion о! Steering Cert. Yes/No
Possession оС Cooks Cerl. Yes/No
ALL RATINGS
VERY GOOD POOR VERY
GOOD POOR
Gener:ll AbllilY '/.
Gener:ll Conducl ."_
Willingness 10 Work
'"РЕТТУ ОFПСI:RS ONL У
1. Serang, Tilldul/Cass:lu, 805иl1, StoIckc..:per
Abllily 10 mainl:lin discipli"l)
Abllily 10 organize & dcleg:lk dlti":5
Slorekeeping CapabllitiJs
2. Ритртап
Knowlcdge оС Pllll1prOOI1l ul1d ~'aIgo operalions
Abllity 35 :1 Fillcr 10 ussisl Ivilll rcp~irs
З. Fitters
Abllity 10 opcra1e Maclline Shop ~ЧliРl11еПI Х
Abllily 10 сапу ои1 minor rcpairs
Х
АЫlitу 10 Weld. G:1s/F:lcctric. Hotlt Х
4. Carpcnter, D.M .11.
Abllily 10 carry 0111gencI:l1 dllks
Proliciency а! Carpenler/D.M.H.
5. ChieC Соо!.:
Gcncral Cooking зЫlitу
6. Pan1ryman Chicf Sleward
Abllity 10 maintain disciplinc
Abllily 10 organize & dclcgale duties
Storekceping capabllili.:s
MEDlCAL SECТION
General health dlril1g period 01' reporl Good/1!sвJr
Number of visits or consltlt:ltiols witll SIHHC doclors I.v..~..t, ..
(Please allach апу reporls) ,
Апу known serious complainl ~.~ :t; .
Approx. питЬес оС da)'s оСС dtlly dщiпg perio.J ul' rJporl !.t.(t !,.,.. .
IC paid 01'( abroud givc ОАТЕ: ="'~~':':';"'--- __о -
:::~:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.::.:::~AI"'''KtJWAlT1AH''
KUWAIT I
КТ . 50~
SON: ·····p· O;·R·:··
essary 10 keep а сору for ship's records. ( '. N.
i'Ol
ЕА
С tltlt:F еtreШЕ'еReге [1ес
"AL KUII" А!ТIАН"
Uepartmenl~ Неа( .. !7..';(.';сс;А(.
АТ:
То CrewAgenls
i R()~ .. з 51
, ; 11' 8643
.~~,~~~=;;;;~~ICAТERING OFFICER CHIEF OFFICER