(i) full name;

(ii) sex;

(iii) date of birth;

(iv) permanent address; and

(v) National Insurance number;

(b) the date of the employee's commencement as a classified person in present employment;

(c) the nature of the employee's employment;

(d) in the case of a female employee, a statement as to whether she is likely to receive in any consecutive period of three months an equivalent dose of ionising radiation for the abdomen exceeding 13 mSv;

(e) the date of last medical examination or health review carried out in respect of the employee;

(f) the type of the last medical examination or health review carried out in respect of the employee;

(g) a statement by the appointed doctor or employment medical adviser made as a result of the last medical examination or health review carried out in respect of the employee classifying the employee as fit, fit subject to conditions (which should be specified) or unfit;

(h) in the case of a female employee in respect of whom a statement has been made under paragraph (d) to the effect that she is likely to receive in any consecutive period of three months an equivalent dose of ionising radiation for the abdomen exceeding 13 mSv, a statement by the appointed doctor or employment medical adviser certifying whether in his professional opinion the employee should be subject to the additional dose limit specified in paragraphs 5 and 11 of Schedule 4;

(i) in relation to each medical examination and health review, the name and signature of the appointed doctor or employment medical adviser;

(j) the name and address of the approved dosimetry service with whom arrangements have been made for maintaining the dose record in accordance with regulation 21.