MANAPPURAM CERTIFICATE OF PHYSICAL FITNESS
MANAPPURAM CERTIFICATE OF PHYSICAL FITNESS
Physical Examination
1 Anemia Yes No
2 Clubbing Yes No
3 Cyanosis Yes No
4 Odema Yes No
5 Blood pressure
6 Pulse
7 Abdomen and pelvis Normal Abnormal
8 Cardiovascular system Normal Abnormal
9 Respiratory system Normal Abnormal
10 Nervous system Normal Abnormal
11 Ear/Nose/Throat/Eye Normal Abnormal
12 Is he/she a diabetic Yes No
IDENTIFICATION MARKS
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Date : Name :
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