Академический Документы
Профессиональный Документы
Культура Документы
Pre-Employment Medical
Examination Report.
Name :
2. Family History
(of importance)
3. Identification Marks 1]
2]
b] Any Deformity :
5. Height : Exp. :
Weight : Chest :
Complexion : Insp. :
Colour of Eyes :
6. Alimentary System :
Cont….2/-
:2:
a] Urine-Albumin : Microscopy
Sugar Specific Gravity
Deposit Reaction
8. Nervous System
9. Cardio-Vascular System
b] 2nd Rg.
(Where necessary)
a] Speech :
Cont…4/-
:4:
Left Hand
Note: Please attach Eye Specialist’s report and X-Ray report as per the direction given
in Col.No. 11 above.
Annexure – A
Left Eye :
Right Eye
Left Eye
Right Eye
Left Eye
IV. Conclusion :
V] Pulmonary Vasculature :
Date :