[별지 제24호 서식] <개정 2023. 7. 14.>
자격증번호 : (CERTIFICATE NO.) 의료관리자자격증 CERTIFICATE OF QUALIFICATION TO PROVIDE MEDICAL CARE		사진 가로 3.5cm 세로 4.5cm
성명 생년월일 (NAME) (DATE OF BIRTH) 위 사람은 「선원의 훈련ㆍ자격증명 및 당직근로의 기준에 관한 국제협약」 및 「선원법」 제85조에 따라 의료관리자의 자격이 있는 사람임을 증명합니다. Under the provisions of paragraph 2 of Regulation VI/4 in the International Convention on Standards of Training, Certification and Watchkeeping for Seafarers, 1978, as amended, and the article 85 of Seafarers Act, it is certified that the above mentioned person is qualified to provide medical care on board. 발급일시: (DATE OF ISSUE) 발급기관: 「선원법」 제158조에 따라서 해양수산부장관의 위탁을 받은 (ISSUED BY) 한국해양수산연수원장 □ SIGNED PRESIDENT OF THE KOREA INSTITUTE OF MARITIME AND FISHERIES TECHNOLOGY, AUTHORIZED BY THE MINISTER OF OCEANS AND FISHERIES, THE REPUBLIC OF KOREA, IN ACCORDANCE WITH ARTICLE 158 OF THE SEAFARERS ACT.
	148mm×210mm (인쇄용지<특급> 120g/㎡)