Form PS-05-29A at a glance
What it is: PREGNANCY CERTIFICATE, FORM PS-05-29A (901-1361) (Rev. 4/71): Original: Local file. Duplicate: Captain of flight. Triplicate: Passenger.
Who signs: "I certify that I have examined (1) on (2) and have found her physically able to travel by Air from (3) to (4) on (5) and that the estimated date of birth of the baby is (6) Date (7) Signed (8) Physician".
A filled-in Form PS-05-29A example: a physician certifies a passenger

How to fill out Form PS-05-29A, box by box
Sources
[1] Form PS-05-29A (Rev. 4/71), Pregnancy Certificate (the Official source link on this page).

