Page:United States Statutes at Large Volume 59 Part 2.djvu/348

 1014 TREATIES [59 STAT. International Sanitary Convention for Aerial Navigation, 1944 AIRCRAFT DECLARATION OF HEALTH (International Form) (To be completed by the Commander of an arriving aircraft and handed to the Health Officer of the aerodrome) Airport of Entry (1) Aircraft License No. Nationality or Registration Mark (2) Aerodrome and Date of Departure (3) Aerodromes at which the aircraft alighted during the voyage and date of departure from each: Aerodrome Date Aerodrome Date (4) Number of crew (5) Number of passengers (6) Number of passengers disembarking (7) Has any person left the aircraft during the voyage on account of illness? (8) Has there been any case of illness (other than air sickness) during the voyage? (9) Has the aircraft been disinsectized? Give particulars of last three disinsectizations. By whom Place Method Date (10) Have any other sanitary measures been carried out on the aircraft during the voyage? (11) Have you on board any living animals, birds, insects, bacterial cultures, or viruses? I declare that the foregoing statements are true and correct to the best of my knowledge and belief. Date. Signature of Commander Note: The reverse side of this form may be used by the Health Officer for the record of the disposition of aircraft and passengers.

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