PERSONAL DETAILS
Full Name
Holding Of License
Seafarer Code
Place / Date Of Birth
Nationality
Address
Phone
Mobile
E-mail
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Engineer
DOCUMENT OF TRAVEL
No
.
Type of Document
License Number
1.
Passport
A4921008
2.
Seaman Book
B077842
Date of Expiry
Issued At
Date Of
Issued
Expiry
Issued At
Date of Issued
CERTIFICATE OF PROFICIENCY
No
.
1.
2.
3.
4.
Medical Care
5.
Tanker Familiarization
Name of Certificate
Certificate Number
No.
Name of Certificate
1.
ISM CODE
No.
Name of Certificate
1.
Fitness Certificate
SHORT COURSE
Date Of
Issued
Expiry
Certificate Number
Clinical
Evaluation
Name of Ship
Rank
Flag
Issued At
No.
Issued At
GRT
Period
BHP
Vessel
Engine
Sign-On
Sign-Off
1.
MANDIRI
BERAU
Cadet
Inesia
Tug Boat
Yanmar
30 July
2013
14 Feb
2014
2.
MDM
BORNEO
Cadet
Inesia
Tug Boat
Yanmar
7 Maret
2014
11 Augst
2014