[Medical Checkup]-[Your Name]

Mon Sep 07, 2020 11:53 pm

Medical Checkup

San Andreas Fire Medical Departement

A.Information

Name:
Age:
Date Of Birth:[DD/MM/YYYY]
Blood Type:
Number Phone:
Address:
Id Card: (/stats In Game And ScreenShoot)

B.Medical Checkup

what is your reason for making a medical check up:
Do you want to register as a faction, that's why you made a medical checkup:(Yes/No)
Do you have a congenital disease:(Yes/No)
Do you have a mental illness:(Yes/No)

C.declarations

[Your Name]Promise that I will maintain medical check-ups and will not abuse it to protect the good name of myself and those concerned not to use it for crime and I promise I will not lie when checked by the medical team.

Los Santos, [DD/MM/YYYY]

[YOUR NAME]

Code:: [center][img(400px,400px)]https://i.postimg.cc/rFsRn0wk/LGO.png[/img][/center] [hr] [center][size=24][b]Medical Checkup[/b][/size][/center] [center][size=24][b]San Andreas Fire Medical Departement[/b][/size][/center] [center][hr] [/center] [left][b]A.Information[/b][/left] [list] [*]Name: [*]Age: [*]Date Of Birth:[DD/MM/YYYY] [*]Blood Type: [*]Number Phone: [*]Address: [*]Id Card: (/stats In Game And ScreenShoot) [/list] [b]B.Medical Checkup[/b] [list] [*]what is your reason for making a medical check up: [*]Do you want to register as a faction, that's why you made a medical checkup:(Yes/No) [*]Do you have a congenital disease:(Yes/No) [*]Do you have a mental illness:(Yes/No) [/list] [b]C.declarations[/b] [size=18][b][Your Name][/b]Promise that I will maintain medical check-ups and will not abuse it to protect the good name of myself and those concerned not to use it for crime and I promise I will not lie when checked by the medical team.[/size] [hr] [right][size=18]Los Santos, [DD/MM/YYYY][/size][/right] [right][size=18][YOUR NAME][/size][/right]