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JJ Keller 19MP (47999) Medical Exam Report, Certificate & Registry - Rev. 3/16

3 / 2016 Revision. Complies with Medical Examiner's Certification Integration Final Rule Beginning December 22, 2015

Helps you comply with 49 CFR §391.43
The Medical Examination Report, Medical Examination Certificate/DOT Medical Card, and the Medical Examiner's National Registry Verification are required by the DOT


Medical Examination Report - 47375 (761-F)
Complies with Final Rule published April 23, 2015
Helps you comply with 49 CFR §391.43
9 pages long
Contains applicable regulations, instructions to the medical examiner, and the form itself
Measures 8-1/2 inches x 11 inches


Medical Examiner's Certificate - Laminated Paper Format (DOT Medical Card) - 47379
Complies with Final Rule published April 23, 2015
Helps you comply with 49 CFR §391.43
Self-laminating; front laminate protects the driver copy
Two plies
Tri-fold
Overall measurement 3-1/2 inches x 7-1/8 inches, Certificate detached 3-1/2 inches x 6-1/2 inches
Folded measurement 3-1/2 inches x 2-3/16 inches


Medical Examiner's National Registry Verification - 27034 (758-FS-C2)
Snap out format
Two plies
Carbonless
Complies with DOT's 49 CFR §391.23 and §391.51
Required to be used as of May 21, 2014
Measures 8-1/2 inches x 11-3/4 inches

JJ Keller Model 19MP (47999)


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