Vacation Resort in the Bahamas | Atlantis Paradise IslandB. c. BAHAMAS IMMIGRATION INWARD PASSENGER...
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Transcript of Vacation Resort in the Bahamas | Atlantis Paradise IslandB. c. BAHAMAS IMMIGRATION INWARD PASSENGER...
MA
RIT
IME
DE
CL
AR
AT
ION
OF H
EA
LT
H
APPE
ND
IX 5 (C
ON
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D)
SCH
ED
UL
E T
O T
HE
DE
CL
AR
AT
ION
PA
RT
ICU
LA
RS O
F EV
ER
Y C
ASE
OF IL
LN
ESS O
R D
EA
TH
OC
CU
RR
ING
ON
BO
AR
D
N
AM
E
CL
ASS
OF
RA
TIN
G
AG
E
SEX
N
AT
ION
AL
ITY
D
AT
E O
F EM
BA
RK
ING
N
AT
UR
E O
F IL
NE
SS D
AT
E O
F OFF-SE
T
RE
SUL
T O
F IL
NE
SS D
ISPOSA
L O
F C
ASE
*State whether recovered:_______ Still Ill:______ D
ied: ______
______________________________
MA
STER’S SIG
NA
TUR
E
