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Amver SAR(Q) form
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Required fields are indicated in red (with *)
Information contained in this form will only be used to support safety of life at sea.
*
E-mail
Basic Vessel Information
*
:
*
Vessel Name
*
Vessel Call Sign
IMO #
Medical Personnel
*
:
Medical doctor / physician normally carried
Physician's assistant or paramedic normally carried
Nurse normally carried
No medically trained personnel normally carried
Communications Capability:
INMARSAT:
A
B
C
M
Other
Radio Watch Schedule:
H24-Continuous
H16-ITU SKED
H8-ITU SKED
HX Unspecified
Completed by
*
:
*
Name
Title
*
Date
*
Copy the text above (case sensitive):
Information contained in this form will only be used to support safety of life at sea.
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Last Modified 5/18/2009
