Dear All, Please provide Format of Medical Fitness for the new employee, who needs to fulfill this formality before joining. Regards, Vivek
From India, Panipat
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7From India, Panipat
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PRE-EMPLOYMENT MEDICAL EXAMINATION
From To
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
PHYSICAL EXAMINATION
Height Weight : ..
Chest Expansion
Inspiration Expiration :
BLOOD PRESSURE :
Lying Standing :
Anemia Jaundice Lymphadenopathy Edema
SYSTEM EXAMINATION :
Respiration :
CVS :
CNS :
ABD :
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)):
From India, Hyderabad
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From To
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
PHYSICAL EXAMINATION
Height Weight : ..
Chest Expansion
Inspiration Expiration :
BLOOD PRESSURE :
Lying Standing :
Anemia Jaundice Lymphadenopathy Edema
SYSTEM EXAMINATION :
Respiration :
CVS :
CNS :
ABD :
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)):
From India, Hyderabad
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Pre Medical Employment check.doc
ESIC Form-Medical Expense Reimbursement.p df