President Trump’s doctor said the commander-in-chief is in “exceptional health” following his “semiannual physical” at Walter Reed National Military Medical Center in Maryland on Friday.

During his physical, the president received “preventive health screenings and immunizations,” including a flu shot and COVID-19 booster vaccination, according to a memorandum from Trump’s physician Sean Barbabella.

These screenings and immunizations were in preparation for his “upcoming international travel,” Barbabella said. Trump plans to fly to Egypt and Israel early next week as part of the implementation of his peace plan between Israel and Hamas, which both parties have agreed to, following two years of war.

“President Trump continues to demonstrate excellent overall health,” Barbabella wrote. “He continues to maintain a demanding daily schedule without restriction.”

The physician added that the president exhibits “strong cardiovascular, pulmonary, neurological and physical performance.”

While White House press secretary Karoline Leavitt previously called Trump’s physical on Friday  a “routine yearly checkup,” Trump’s last physical was in April. At that appointment, Barbabella wrote in a three-page summary of the exam that Trump was “fully fit” to serve.

Trump had another appointment in July, in which Barbabella said the president was diagnosed with chronic venous insufficiency, “a benign and common condition, particularly in individuals over the age of 70.”

“Additionally, recent photos of the president have shown minor bruising on the back of his hand, Barbabella wrote. ”This is consistent with minor soft tissue irritation from frequent handshaking and the use of aspirin, which is taken as part of a standard cardiovascular prevention regimen. This is a well-known and benign side effect of aspirin therapy.”

Trump was photographed with make-up covering the bruising seen on his hands this summer.

Despite the diagnosis, Barbabella wrote in the July memo that Trump “remains in excellent health.”