@-Medical Information Sheet Client personal details Client identity details UMUUDOESE 1985, Visit date: 21 Jun 2019 Family name: MAIGUA TERAN Identity document presented: Original Passport Given names: Marco Antonio Identity document number: 1003202866 Gender MALE Issuing country: ECUADOR. Date of bit: 13 Dec 1990 Date of issue 19 Dec 2018 Country of bith ECUADOR Date of expiry 19 Dec 2024 Source Clinic Client visa details IME Non EDE Uplront medical type: Visor Instructions to the client ‘This information sheet outines the status of tho immi Medical cin "Note: the status ofan ind been submitted io Immigration, Refugees and C ‘ater you have let the cine, Your heath caso willbe submitted to IRCC for procossk {quite to complete further health examinations, further information on IRCC's health a Not: + Once a panel cline has subr ‘pplicalon and/or your heath exarn ot be able fo lp you with these queries, + Myou have not yt lodged a vi UMA UCL IME occ Pasa tea fot RCC. Ts wa facaas Health Case Status = ‘This heath case has not yet been submited to IRGC Bam — fe iacial Beaman — Generated 21 Jun 2019 03-49 Pia igration heath examina vidual examination wil not appear as “Complete in the Eas itizenship Canada IRC). This may mitted your health examination ination resus should be Dce88ing Of Your Visa application, yOu will be notiied by IRGC once yours s8e8sment proces The atalus oF the individual exarninations ie Cine VL Maio UME Uo04341905 Stat at a pane ci do he heath kone on the yp fests 0 IRGC, any hrther queries about you visa office Page to 2ary of Payments (Claim # 865288) Homi Deposit j=May-2019 Immigration Deposit 28-May-2019 Calls: 1 ‘Payment Note $ 50.00 $50.00) Printed: 28-May-2019 11:11 AM21-Sun-2019 Outstanding Balance: Printed: 25-30 2019 9:48 PU