Certificate

MSE-011 No. 651063
(issued to the disabled person)

Shulzhenko Tatyana Vasilyevna
last name, first name, patronymic

• Date of birth: 1950
• Date of examination: 01.10.01
• Examination: repeated
• Disability group: second
• Indicated in words:
• Cause of disability: general illness

Disability established for a period until September 1, 2002
Date of next re-examination: July 01, 2002

TRUE COPY
Investigator Romanovsky V.V.

[Seal: FEDERAL SECURITY SERVICE OF THE RUSSIAN FEDERATION * INVESTIGATIVE DEPARTMENT * FOR INQUIRIES 3]

Issuing Authority Information:

Ministry of Labor and Social Development of the Russian Federation
Rostov Region, Volgodonsk
City Bureau of MSE No. 1
type, profile of the state medical and social expertise service institution

Legal Note:
The decision of the state medical and social expertise body is mandatory for execution by the relevant state authorities, local self-government bodies, as well as organizations regardless of organizational and legal forms and forms of ownership (Art. 8 of the Federal Law 'On Social Protection of Disabled Persons in the Russian Federation').

Publication Details:

• © Konstr. Publishing House 'Rosblankizdat', 1996
• Publishing House 'Rosblankizdat', a5, order 60, X-96, tel. 3093500
• LR No. 010319 dated 26.12.94
• 103009, Moscow, B. Dmitrovka St., 23/8, tel. 229-37-10, 209-47-92 © FGUP 12