Certificate No.
FHC2021181399
NAIROBI CITY COUNTY
The Food and Chemicals Substance Act (CAP 254)
CERTIFICATE OF MEDICAL EXAMINATION
FORM D
I hereby certify that I have examined STACY KWAMBOKA NDEMO of ID 39025867 and that in my opinion (s)he is
fit under the Food, Drugs and Chemical Substance Act CAP 254 (Food Hygiene regulations) to work at:
Company: Art Caffe Coffe & Bakery Limited
Plot No: 36/V11/1059
Road: EASTLEIGH
Sub County: Kamkunji
Examined At: Mayfair Health Services LTD
Date Examined:
Document No: FHC2021181399
Lab Ref. No./FHC:
Sign:
medical Officer of Health
Date 03/19/24
Serial No: FHC2021181399
NB: This Certificate is valid for six (6) Months Only Expiry Date: 10/02/24
City Hall Governor's Office, F: 22217704 | Tel: 2224281
P.O. Box 30075 - 00100 Nairobi, Email: gorvernor@nairobicity.go.ke
Kenya Website: nairobi.go.ke