(1) Port of arrival; (2) date; (3) ship’s name & IMO No.; (4) ports from & to;
(5) flag; (6) master’s name; (7) gross tonnage; (8) valid Sanitation Control Exemption/Control Certificate carried? (9) Re-inspection required? (10) Has ship visited an affected area identified by WHO? (11) ports of call from commencement of voyage or in past 30 days; (12) if requested: list of all persons who have joined ship since international voyage began or in past 30 days; (13) number of crew members; (14) number of passengers; (15) nine health questions as follows: (1) Has any person died on board died on board during the voyage otherwise than as a result of accident? (2) Is there on board or has there been during the international voyage any case of disease which you suspect to be of an infectious nature? (3) Has the total number of ill passengers during the voyage been greater than normal/expected? (4) Is there any ill person on board now? (5) Was a medical practitioner consulted? (6) Are you aware of any condition on board which may lead to infection or spread of disease? (7) Has any sanitary measure (e.g. quarantine, isolation, disinfection or decontamination) been applied on board? (8) Have any stowaways been found on board? (9) Is there a sick animal or pet on board?
