|
View ESA-OWCP's Form 1215-0103 Online 
| Agency: |
ESA-OWCP |
| Title: |
OWCP-5b, Work Capacity Evaluation For Cardiovascular/Pulmonary Conditions |
| Form Description: |
OWCP-5b, Work Capacity Evaluation For Cardiovascular/Pulmonary Conditions: Attending physicians use this form to report on a federal employee's work capacity limitations due to cardiovascular/pulmonary conditions he/she has reported. |
| OMB Control Number: |
1215-0103 |
| OMB Expiration Date: |
Friday, September 30, 2011
|
| |
|
