OCCUPATIONAL HEALTH CENTRE
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Visitor Medical Examination
Run Time :
Ticket No.:
OHC Reporting Time :
Patient Name:
Father Name:
Age:
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Gender:
Department:
Designation:
Cadre:
Employer/Contractor:
SBP:
DBP:
Heart Rate:
FBS:
RBS:
PPBS:
Temp:
SPOC2%:
Follow-up to OPD
Remarks/Follow-up Invetigation Details
Complaints :
Examination :
Diagnosis :
Ailment System :
Additional Treatment Recommendations(if Any):
Referral:
Follow-up:
Advices:
Precautions:
Medical Tests Recommended:
Followup-Remarks:
Reviewed By: