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Medical Declaration

Please select the pre-existing conditions which are applicable to you and your family
a	Cancer / Leukemia / Malignant tumor
b	Chronic obstructive lung disease / Progressive lung disease.
c	Thalassemia / Anemia other than iron deficiency anemia
d	Insulin dependent diabetes.
e	Cardiac ailments. (Other than where Angioplasty or Bypass done 1 year prior to trip start date)
f	Major organ failure (Kidney / Liver / Heart / Lungs etc)
g	HIV / AIDS
h	Neurological disorder / Stroke / Paralysis / Coma
i	Hepatitis B or C / Crohns disease / Ulcerative colitis
k	Autoimmune disorder / Systemic Lupus Erythematosus