MARITIME DECLARATION OF HEALTH
(To be rendered by the masters of ships arriving from ports outside the territory)
Port of CAUCEDO Date 05.03.2024
Name of ship MAHAWELI From KINGSTON to POINT LISAS
Nationality SINGAPORE Master's name Capt. LOBOV, Vladimir
Net registered tonnage 7,951
Ship Sanitation Control
Derating or Derating Exemption Certificate : Exemption Certificate Exp. Date: 27.08.2024
Issued at : CARTAGENA, COLOMBIA
INTERNATIONAL WORLD HEALTH ORGANISATION
Cabin NIL Number of crew 20
Number of passengers
Deck NIL
List of ports of call from the commencement of voyage, with dates of dep: See attached
PLEASE SEE PORT OF CALL LIST
HEALTH QUESTIONS Answer
Yes or "No"
1 Has there been on board the voyage *any case or suspected case of plauge,
Cholera, Yellow fever, Smallpox, Typhus or relapsing fever? Give particulars
in the Schedule NO
2 Has Plague occurred or been suspected among the rats or mice on board during
the voyage * or has been an abnormal mortality among them? NO
3 Has any person died on board during the voyage * otherwise than as a result of
an accident? NO
4 Is there on board or has there been during the voyage *any case of disease
which you suspect to be of an infectious nature? Give me particulars in Schedule NO
5 Is there a sick person now? Give particulars in Schedule. NO
6 Are you aware of any other condition on board which may lead to infection
or the spread of a disease? NO
7 Has any sanitary measure (e.q. quarantine, isolation, desinfection or
decontamination) been applied on board? NO
8 Have any stowaways been found on board? NO
9 Is there a sick animal or pet on board? NO
Note.- In the absence of surgeon, the Master should regard the following symptoms as
ground for suspecting the existence of disease of an infections nature
(a) fever, persisting for several days or accompanied by (i) prostration; (ii) decreased
consciousness; (iii) glandular swelling; (iv) juandice; (v) cough or shortness of breath;
(vi) unusual bleeding; or (vii) paralysis.
(b) with or without fever; (i) any acute skin rash or eruption, (ii) severe vomiting
(other than sea sickness); (iii) severe diarrhoea; or (iv) recurrent convulsions.
I hereby declare that the particulars and answers to the questions given in this Declaration of Health
(including the Schedule are true and correct to the best of my knowledge and belief.)
Signed :
Capt. LOBOV, Vladimir
Counter signed : N/A
Date 03-Mar-24 Ship's Surgeon
* If more than four weeks have elapsed since the voyage began, it will suffice to give particulars for the last four weeks.
