Scribd Logo
Upload

Welcome to Scribd!

  • 688 views

    Proforma For Medical Certificate

    Uploaded by

    viralpro videos
    This document is a physical examination form for a medical fitness certificate. It collects personal information about an individual such as name, age, sex, and passport number. It documents measurements of height, weight, blood pressure, and examines areas of the body like the eyes, heart, lungs, abdomen, and neurological system. It also lists medical test results for blood group, syphilis, HIV, hepatitis, and urine. At the bottom, the examining medical officer will indicate if the individual is deemed medically fit, unfit, or if a determination is deferred.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Proforma For Medical Certificate

    Uploaded by

    viralpro videos
    688 views1 page
    This document is a physical examination form for a medical fitness certificate. It collects personal information about an individual such as name, age, sex, and passport number. It documents measurements of height, weight, blood pressure, and examines areas of the body like the eyes, heart, lungs, abdomen, and neurological system. It also lists medical test results for blood group, syphilis, HIV, hepatitis, and urine. At the bottom, the examining medical officer will indicate if the individual is deemed medically fit, unfit, or if a determination is deferred.

    Original Title

    Proforma for Medical Certificate.doc

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a physical examination form for a medical fitness certificate. It collects personal information about an individual such as name, age, sex, and passport number. It documents measurements of height, weight, blood pressure, and examines areas of the body like the eyes, heart, lungs, abdomen, and neurological system. It also lists medical test results for blood group, syphilis, HIV, hepatitis, and urine. At the bottom, the examining medical officer will indicate if the individual is deemed medically fit, unfit, or if a determination is deferred.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    688 views1 page

    Proforma For Medical Certificate

    Uploaded by

    viralpro videos
    This document is a physical examination form for a medical fitness certificate. It collects personal information about an individual such as name, age, sex, and passport number. It documents measurements of height, weight, blood pressure, and examines areas of the body like the eyes, heart, lungs, abdomen, and neurological system. It also lists medical test results for blood group, syphilis, HIV, hepatitis, and urine. At the bottom, the examining medical officer will indicate if the individual is deemed medically fit, unfit, or if a determination is deferred.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 1

    PHYSICAL EXAMINATION FOR MEDICAL FITNESS CERTIFICATE

    No ____/__________/ Dated.______________

    Mr./Ms./Mrs.______________________________________________________________________

    S/O, D/O, /W/O.___________________________________________________________________

    Age. _______Sex. _____________Designation.__________________________________________

    Place of Birth. _________________________ Passport # _________________________________

    Country applied for.________________________________________________________________

    General Examination:

    Height_______ Weight ________ Physical Deformity (if any) ____________________________

    B.P._____________ mmHg, ______min, Pallor______________ Clubbing__________________

    Lymph node___________ Thyroid ___________ Skin__________________________________

    Eye Sight: Hearing:

    Right Eye _______________ Right Ear__________________

    Left Eye_________________ Right Ear__________________

    Heart __________________ Chest_____________________

    Abdomen_______________ C.N.S____________________

    Investigations:

    X-Ray Chest ___________________ Blood Group_______________

    Blood CP&ESR_________________ VDRL Syphilis_____________

    Urine R/E _____________________ HIV______________________

    Anti HCV/HB AG’s ______________ Any other_________________

    Remarks: FIT / UNFIT / DEFERRED

    (To be signed and stamped by authorized


    Medical Officer of Government Hospital)

    Page 1 of 1

    You might also like

    pFad - Phonifier reborn

    Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

    Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


    Alternative Proxies:

    Alternative Proxy

    pFad Proxy

    pFad v3 Proxy

    pFad v4 Proxy