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Petkovski Dame Health Centre Skopje ________838__________

(name) Sector of Primal Health “Gazi Baba” (No. of health record)


Braka Miladinovci Skopje ______ 17.05.1991_______
(school) (date of birth)

_____Deljadrovci________

MEDICAL EXAMINATION
Class I III V VII I2 III2
Date of examination 07.10.97 21.10.99 22.10.01 16.10.03 19.12.05 28.11.07
Weight in kg. 22.9 27.5 33.5 59 59 65
Height in cm. 120 130 139 169.5 175
Hygiene OK OK OK OK OK
Presence of lice ОК ОК ОК ОК ОК
Skin OK OK OK OK OK
Body posture OK OK OK OK OK
Body development Middle OK OK OK OK
Body nutrition Middle OK OK OK OK
Spine OK OK OK OK ?
Chest OK + OK OK OK
Feet deformities + + + OK OK
Skeleton deformities OK OK OK OK OK
Eye diseases OK OK + OK OK
Sight (left - right) OK OK + OK OK
Ear diseases OK OK OK OK OK
Hearing (left - right) OK OK OK OK OK
Nose OK OK OK OK OK
Mouth, Throat, Tonsils OK OK OK OK OK
Lymph glands OK OK OK OK OK
Teeth
Thyroid gland OK OK OK OK OK
Heart OK OK OK OK OK
Lungs OK OK OK OK OK
Abdominal organs OK OK OK OK OK
Organ diseases of the nerve
OK OK OK OK OK
system
Psychological development OK OK OK OK OK
Speech defects OK OK
Puberty OK
First menstruation
Other pathological findings OK OK OK

Судскиот преведувач, Ацо Пешевски 07-358/1, ја потврдува автентичноста на овој документ.


The judicial interpreter, Aco Peshevski 07-358/1, verifies the authenticity of this document.
Blood pressure 100/70
CE
H6 105 110 122 137.9 143.3
Urine OK OK OK OK
Parasites in the feces
General health condition OK
Ability to do exercises at
OK
the PE class

WARNING: The dates, the values and the lab findings should be written, and the clinical part of the examination is marked as follows: with
normal findings OK should be written; with pathological findings + should be written and the finding is written with the same date.

MEDICAL EXAMINATION FINDINGS RECORD

Date of the examination Findings Therapy Employer


Pedes plani
07.10.97
Anemia
21.10.99
Pectus Infudibuliforme

Myopia
22.10.01 Pedes plani

Prim. MD. Elida


Myopia
19.12.05 Stojanovska Ristovska
401447

JUDICIAL INTERPRETER
___________________
Aco Peshevski

Судскиот преведувач, Ацо Пешевски 07-358/1, ја потврдува автентичноста на овој документ.


The judicial interpreter, Aco Peshevski 07-358/1, verifies the authenticity of this document.

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