Dear All, Please provide Format of Medical Fitness for the new employee, who needs to fulfill this formality before joining. Regards, Vivek
The Human Resources Department Senior Medical Officer
Kindly examine Mr/ Mrs./Miss ..who is being considered for our employment at our Life Spring Hospitals.
Date : Signature
Height Weight : ..
Inspiration Expiration :
BLOOD PRESSURE :
Lying Standing :
Anemia Jaundice Lymphadenopathy Edema
SYSTEM EXAMINATION :
PAST HISTORY : Asthma, Heart Disease , TB, Hepatitis, Chicken pox, Depression,
Major psychiatric disorder, Epilepsy, Drug and alcohol dependence,
Any other etc.
Allergy : Any Medication Latex
PRESENT STATUS ON INVESTIGATIONS :
REMARKS : FIT/ UNFIT/ TEMPORARILY UNFIT.
SIGNATURE OF THE DOCTOR WITH DATE :
NAME OF THE DOCTOR ((in block letters)):
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