Translation from Romanian

County Town Health Unit Official stamp

Card No. / Health book 470

MEDICAL CERTIFICATE This is to testify that: Ciobanu Adriana Born: 1974, month 07 day 20 gender M-F

Domiciled in : County Cluj Town Cluj-Napoca, Gladiolelor street, no. 1/10 Holding the position of: Suffering from: She is not in our chronic neurological, psychological or motional disease records. The present has been issued to serve for: able to work within England.

Date of issue: Year 2013 month 03 day 25

Doctors signature and stamp, - stamp and illegible signature Dr. STURZ FABIOLA SPECIALIST DOCTOR GENERAL MEDICINE Code D 33122

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