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Medical Checkup Format

This document is a corporate medical checkup report for a pre-employment screening. It includes sections on the patient's personal details, medical history, physical examination findings, lab test results, physician's impression, and a recommendation on fitness for employment. The physical exam and routine tests were all within normal limits, and the physician deemed the patient fit for employment.

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Linson Johnson
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28K views

Medical Checkup Format

This document is a corporate medical checkup report for a pre-employment screening. It includes sections on the patient's personal details, medical history, physical examination findings, lab test results, physician's impression, and a recommendation on fitness for employment. The physical exam and routine tests were all within normal limits, and the physician deemed the patient fit for employment.

Uploaded by

Linson Johnson
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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Corporate medical checkup report Routine/ pre-employment Name of patient:

Name of Firm:

Age: Sex:

I.D. No: Date: For PRE- EMPLOYMENT CHECKUP REF. FROM M/S. M/SMAHINDRA HOLIDAYS AND RESORTS LTD.

1. CHIEF COMPLAINTS AND HISTORY OF PRESENT ILLNESS: 2. PAST HISTORY: 3. PERSONAL HISTORY: SMOKING:PHYSICAL ACTIVITY: 4. FAMILY HISTORY: 5. PHYSICAL EXAMINATION: Height: IDENTIFICATION MARKS GENERAL: Normal Heart: Pulse Lungs: Abdomen: Nervous System: Genito Urinary: Other Relevant Findings (Including ENT, eyes, Dental) B.P Heart sound Murmur Weight: ALCOHOL:DRUG ALLERGY:-

Investigations: Routine Blood Count: HGB: PCV: Blood Sugar: Random: TC: DC: ESR:

Blood Group & Rh Factor:

Other tests:

Platelet count

: Sugar:

Urine analysis: Albumin: ECG: X-ray Chest:

IMPRESSION RECOMMENDATION The Physical examination and the routine investigation under M/s. MAHINDRA HOLIDAYS AND RESORTS LTD PEC package are within normal limits: OPINION REGARDING FITNESS:

Physicians signature

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