Supplement Document for the Special Tourist Visa Application I,………………………………………………………………………………., ……………………………….(nationality), the holder of passport No……………………………………………………, hereby confirm with the Royal Thai Embassy in Oslo that I do not have the following diseases, namely - Leprosy, - Tuberculosis, - Elephantiasis, - drug addiction, and - third phase of Syphilis. I certify that the information given herein is true and correct. (………………………………………………………………………) Signature (………………………………………………………………………) Date/Month/Year
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