Please visit any of the below mentioned places for a medical check up.

Please pay the fees (Rs 450 only) and preserve the receipts for reimbursement
upon joining.
LIST OF HOSPITALS

1) NOBLE HOSPITAL
Dr.S.K.Raut
Corporate Health Checkup Dept.
NOBLE HOSPITAL,
153,Magarpatta City Road,OFF Sholapur Road,
Behind Megacenter, Pune. 411 013
E-mail skrcorporate@yahoo.co.uk
Contact phone no 020-66285120 Mrs Soni for appointment
Mr Praful Hirurkar cell 9881693142, Dr SK Raut 9423581029
2) JEHANGIR HOSPITAL
Health Checkup Dept
32 Sassoon Road
Pune 411001
Phone : 020 26050550
Fax : 020 26050866
E-mail raju.pardeshi@jehangirhospital.com
Contact Person : Shilpa or Poonam from health check-up depart
For Appt please call : 020 26050550 Ext 4006 from 8am to 5 pm
In case of emergency : Mr Raju Pardeshi ( 9890047523 )
3) DEOYANI HOSPITAL
Dr Shrirang Limaye
Dahanukar Colony Circle, Off Karve Road,
Kothrud, Pune 411038
E-mail deoyanihospital@gmail.com
Contact phone no 25436380, 9881901723
Contact Person , Mrs Gauri Deshpande, Dr Shrirang Limaye

Pre-Employment Medical Examination Report

(TACO GROUP)
Name: -------------------------------------------- Age-------- Sex--- M / F
Identification mark---------------------------------------------------------GENERAL EXAMINATION
Height --------------cms-

Weight --------------kg

Chest: Inspiration--------cm Expiration----------cm

Breath Holding --------Seconds

Build: Strong / Average / Poor

Oral / Dental Hygiene: Good / Poor

Nails-------------------- Thyroid--------------

Lymph Nodes-----------

SYSTEMIC EXAMINATION
A) Cardio-Vascular System
Pulse------------/ min.---- Regular / Irregular
B.P.---------------mm of Hg

Peripheral pulses-------

Heart sounds---------------Abnormality----------

B) Respiratory System
Shape of chest ------------------Chest movement-----------------Respiratory rate----------Trachea--------------- Breath Sounds--------------------C) Gastro-Intestinal System
Liver-------------Spleen----------------- Hernia--------------

Lumps---------

D) Central Nervous System

Higher Functions------------Sensory System------------Motor System---------Tendon Reflexes--------------Posture / Gait--------------Psychological Make up-----------

E)
Examination of Eyes
Vision: Near --------- Distant Rt 6 / ----, Lt 6 / ---- Color Vision: Normal / Defective
Power of glasses if any and vision with glasses----------------------------------Squint / Nystagmus if any
F) Ear / Nose / Throat---------------------- Hearing / normal conversation-----------G) Genito-Urinary System
Hernia / Hydrocele / Varicocele------------- Varicose veins--------------H) Musculo-Skeletal System
Superior Extremities------------------------Inferior Extremities-------- Spine------I) Skin Diseases--------------------------------------------

INVESTIGATIONS (Reports to be attached)

1) Haemogram
2) Blood sugar, Random
3) Urine RE / ME
4) ECG
Other tests as advised ---------------------------------------------------------------------------------------------------General Remarks-------------------------------------

Fitness:

FIT

UNFIT

Signature of Physician

DECLARATIOIN BY CANDIDATE
Personal and Family History of
1) Asthma---2) Heart Disease---3) B.P. ---4) Fits---5) Diabetes---6) T.B. ---7) Accidents-8) Operations----9) Kidney disease---10) Fractures-----11) Psychiatric problem----12)
other
If yes give details------------------------------------------------------------------------------------Personal Habits
Alcohol---------Tobacco / Smoking-----------Allergies-------------Other

I declare that the above information is true and correct to the best of my knowledge.
If any of this information is found to be false / incomplete / incorrect, the Company can
cancel my appointment or terminate my service contract

Date: -------------------

Signature of Candidate