Name:No.:
Date of birth, gender of origin, male and female
department
Professional experience and years
Medical/medical records
Blood group color blindness □ none □ color blindness □ red green □ red color blindness □ green color blindness.
date
project
Height cm
Weight kg
Chest circumference centimeter
Blood pressure mmhg///////
Left eye vision (correction)
Right (after correction)
Listen to the left
correct
Grasp to the left
correct
eye
ear
nose
tooth
thyroid
lymph node
liver
heart
respiratory apparatus
Circulatory organ
tendon reflex
Skin skin
cultivate
Examining doctor
check the date
Chest x-ray
Hemoglobin
Red blood cell
world boxing council
Venereal disease research laboratory sexually transmitted diseases research laboratory
Date of urine test
Vaccination frequency
kind
1
2
three
four
five
six
hepatitis B
hepatitis C
Date special record doctor's signature
If not, here is another example.
Occupational health list
No.: 0908 130567 ID card: (other people who have left their jobs but are not employed)
Name, gender, male age, 24 persons.
unit
(Suzhou) Wireless Communication Products Co., Ltd. Job Noise
Internal medicine heart: heart rhythm, no murmur, heart rate: 80 beats/min.
Lung: Breathing sounds in both lungs are clear. Blood pressure: 16/ 1 1 KPa.
Surgical nerve: skin:
Height: 173 CM Weight: 68 KG Limbs: There is no abnormality in shape and motor function.
Thyroid gland: no swelling spine: physiological curvature, normal mobility lymph nodes: no swelling in neck and submaxillary.
Otolaryngology: Normal Ear: Normal
Pharyngeal: Normal Other:
Ophthalmic vision naked eye left: 4.3 right: 4.0 color discrimination: normal.
Correct left: right: other:
There was no obvious abnormality in liver, gallbladder and spleen by B-ultrasound.
Electrocardiogram normal electrocardiogram
Other audiometric tests showed that the hearing of the left and right ears was normal.
X-ray chest film showed no active lesions in both lungs and no abnormal physical examination conclusion in cardiac diaphragm shadow;
Physical examination date: August 2009 13 Attending physician:
Experimental result data table
Project achievement unit reference value Project achievement unit reference value
Blood leukocytes
lymphocyte
intermediate cell
granulocyte
erythrocyte
6.2
1.9
0.3
4.0
5. 19
10E9/L
10E9/L
10E9/L
10E9/L
10E 12/L
4- 10
1-3.3
0.2-0.7
1.8-6.4
3.5-5.5
hemoglobin
Erythrocyte hemoglobin content
Erythrocyte hemoglobin concentration
blood platelet
160
30.8
352
180
Gram/liter
Nigeria
Gram/liter
10E9/L
1 10- 160
28-36
320-360
100-300
Biochemical alanine aminotransferase
Glutamate-oxaloacetic transaminase
General protein
4 1
40
68.7
U/L
U/L
Gram/liter
8-60
5-40
60-80
albumin
globulin
White ball ratio
48.32
20.4
2.4
Gram/liter
Gram/liter
35-55
15-35
1.5-2.5