3．放射线技师的声明[ Radiographer’s certification]
☆我证明我对该申请人实施了X光照射，并检查了该表格的照片和签字。
☆放射线技师的签名[Radiographer’s signature]
☆日期[Date]
D部分[Part D]——放射线专家完成[Radiologist to complete]（个人理解是，放射线技师只管拍片子，而看片子上边有没有病是由放射线专家来完成）
☆请使用钢笔并用英文认真填写。字迹模糊者将被返还。
☆任何方面的不正常都应有纪录。[Comment is required on any and all aspects found not to be entirely normal]
☆(所有不正常的部分要给予详细地描述)[Give a full description of all abnormal findings]
1．骨骼和软组织[skeleton and soft issue]
☆正常[Normal]/不正常[Abnormal]
2．心脏投影[cardiac shadow]
☆正常[Normal]/不正常[Abnormal]
3．淋巴腺[lymphatic glands]
☆正常[Normal]/不正常[Abnormal]
4．半隔膜和肋骨膈角[Hemidiaphragms and costophrenic angles]
☆正常[Normal]/不正常[Abnormal]
5．肺部[lung fields]
☆正常[Normal]/不正常[Abnormal]
6．肺结核[evidence of TB]
☆未显示[Absent]/显示[Present]
7. 其他不正常情况 [Details of other abnormalities]
8. 放射线专家的声明[Radiologist’s declaration]
☆我声明我已经检查了X光片并真实记录了检查结果。
☆放射线专家签名，日期
☆全名（请认真填写）
☆地址，联系电话
☆放射线专家请注意: [To the Radiologist]
请将填写完毕的160表格放入附带的信封中。封上信封，并在封口处签名或盖上橡皮章。如果不在澳大利亚本土，请把这个信封附带X光片放入一个外层信封。如果在澳大利亚本土，就不用附带X光片。请把这个信封返还给：直接交给信封上表示的澳大利亚政府办事处，若没有标明地址交给申请人本人;或者若在澳大利亚本土检查的，根据HSA的地区安排。
E部分[Part E]——申请人完成[Applicant to complete]
在你参加放射线检查之前：[Before you attend the radiological examination]
在下表中填写姓名和住址[fill in your name and address in the space below]
回答下边的问题[complete the question below]
这个信封是关于谁的私人医疗档案：[this envelop contains private medical documentation concerning:]
☆姓[family name]
☆名[given name]
☆地址[address]邮编[postcode]
关于澳大利亚签证申请人[in relation to an application for an Australian visa]
☆这份关于放射线检查的申请是否已经提交澳大利亚政府办事处？[Has the application to which this radiological examination is related, already been submitted to an Australian Government office?]
☆没有[no]
如果在澳大利亚本土以外，在检查以后，放射线专家将把你的所有医疗文件放入这个信封（附带X光片）并交到你所提供的以上地址。[If outside Australia after your examination, the radiologist will place all your medical documents into this envelope and forward it to you, with the x-ray attached, at the address you have given above.]
当你提交签证申请时，请务必把这个未开封的信封和X光片一同提交[you must make sure that this unopened envelope and x-ray (if attached) accompanies the application for an Australian visa when it is submitted.]
如果你不是申请提交人，请务必把此信封和X光片交给申请人或者中介人。[If you are not the person submitting the application, make sure this unopened envelope and x-ray (if attached) is given to the person or agent who will be submitting the application.]
注意：如果你还没有提交申请，请注意填写A部分的问题7。[Note-if you have not lodged the application, ensure that Question 7 of Part A is complete.]
☆是的[Yes]
☆相关办事处的名称和地址[name and address of office concerned]
☆我的档案号是[my file number is]
一旦封口，该信封只能由医生小组或澳大利亚政府办事处在审核过程中开封。[Once sealed, this envelope is to be opened only by a panel doctor or the Australian Government office processing the application]
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