Labor ability appraisal application

XXX labor ability appraisal committee:

Injured: Gender : Age:

identification number: Injury time:

Injury site: Work injury certificate number:

Personal Social Security Number: Current unit:

Apply now to do: Identification.

signature of Applicant:

year month day

Application Notes:

1. At the time of application, submit the four-inch one-inch recent photo of the unqualified person; □ 2. The original and a copy of the work injury certificate; □ 3. The original and photocopy of the ID card of the applicant and the appraiser; □ 4. Work injury For all original medical records; □ 5, review and identification must provide all the original copies and copies of the first identification conclusion; □ 6, the old injury recurrence identification must provide: 1 the work injury department introduction letter; 2 the first work injury identification conclusion; 3 All medical records related to work-related injuries; □ 7. For the identification of work ability due to illness, it is necessary to provide a unit power of attorney or to terminate the labor contract certificate;

Labor ability appraisal application

recommended article

popular articles