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Pre-Employment Medical Examination Report: A. Basic Data

This document is a pre-employment medical examination report for an individual selected for a position. The report includes sections on basic data, a clinical examination covering various body systems and measurements, remarks on pathological tests conducted, family history, a conclusion on any further tests or precautions needed, and certification from the medical advisor that the individual is medically fit for employment with no disqualifying conditions.

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Patricia Martin
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101 views3 pages

Pre-Employment Medical Examination Report: A. Basic Data

This document is a pre-employment medical examination report for an individual selected for a position. The report includes sections on basic data, a clinical examination covering various body systems and measurements, remarks on pathological tests conducted, family history, a conclusion on any further tests or precautions needed, and certification from the medical advisor that the individual is medically fit for employment with no disqualifying conditions.

Uploaded by

Patricia Martin
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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PRE-EMPLOYMENT MEDICAL EXAMINATION REPORT

A. BASIC DATA:

1. Name 2. Selected for the position of a) Date of Birth b) Identification marks


3 Unit & Location 4 Date of Joining B. CLINICAL EXAMINATION

: : : :
: :

1. a) Height b) Weight 2. Chest measurements a) Normal b) Expanded 3. Abdomen measurements 4. Blood Pressure 5. Skin 6. Ear, Nose & Throat 7. Vision 8. Respiratory system 9. Circulatory system 10. Nervous system 11. Gastro-intestinal system 12. Genito-urinary system 13. Serious illness or operation in the past 14. Colour Blindness

: : : : : : : : : : : : : : : : :

C. REMARKS ON PATHOLOGICAL TESTS

1. Chest X-ray 2. ECG 3. Complete blood count 4. Urine routine 5. Serum colesterol & blood urea 6. Fasting and post prandial blood sugar 7. Blood group
D. FAMILY HISTORY

: : : : : : :

1. Father 2. Mother 3. Siblings


E. CONCLUSION

: : :

1. Any further investigation required 2. Any precautions suggested


F. CERTIFICATION:

: :

Certified that the above named recruit does not appear to be suffering from any disease communicable or otherwise, constitutional weakness or bodily infirmity except __________________________________. I do not consider this as disqualification for employment in the Company.

Date Place

: :

Signature of the Medical Adviser

Seal of the Medical Hospital

http://www.gobookee.net/medical-certificate-format-for-job/

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