Report of The Examining Authority |
(To be filled in for every medical examination whether initial or periodical or re -examination or after cure/control of disability). |
Annexure to = $para_one ?> |
as result of medical examination on = date_format(date_create($row_form_type_data['approval_date']), "d-M-Y") ?> |
Identification Mark: = $row_med['identity'] ?> |
1.General Development: = $data['general_development'] ?> |
Left Thumb Impression of the Candidate
|
2.Height: = $data['height'] ?>cms |
3.Weight: = $data['weight'] ?>kgs |
4. Eyes: (i) Visual Activity-Distant Vision (with or without glasses,) |
Right Eye: = $data['visual_acuity_distant_vision_rt_eye'] ?> |
Left Eye: = $data['visual_acuity_distant_vision_lt_eye'] ?> |
(ii) Any Organic Disease Of Eyes: = $data['any_organic_disease_of_eyes'] ?> |
(iii) Night Blindness: = $data['night_blindness'] ?>
|
(iv) Colour Blindness: = $data['colour_blindness'] ?> |
(v) Squint: = $data['squint'] ?> |
5. Ears: (i) Hearing: |
Right Ear: = $data['hearing_condition_rt_ear'] ?> |
Left Ear: = $data['hearing_condition_lt_ear'] ?> |
(ii) Any Organic Diseases: = $data['any_organic_disease'] ?> |
6. Respiratory System: |
(i) After Full Inspiration: = $data['after_full_inspiration'] ?> cms |
(ii) After Full Expiration: = $data['after_full_expiration'] ?> cms |
7. Circulatory System: |
Blood Pressure: = $data['systolic_blood_pressure'] . "/" . $data['diastolic_blood_pressure'] ?> mm/Hg |
Pulse: = $data['pulse'] ?>/Min |
8. Abdomen: |
Tenderness: = $data['tenderness'] ?> |
Liver: = $data['liver'] ?> |
Speen: = $data['spleen'] ?> |
Tumour: = $data['tumour'] ?> |
9. Nervous System: |
History Of Fits or Epilepsy: = $data['history_of_fits_or_epilepsy'] ?> |
Paralysis: = $data['paralysis'] ?> |
Mental Health: = $data['mental_health'] ?> |
10. Locomotory System: = $data['locomotory_system'] ?> |
11. Skin: = $data['skin'] ?> |
12. Hydrocele: = $data['hydrocele'] ?> |
13. Hernia: = $data['hernea'] ?> |
14. Any Other Abnormality: = $data['any_other_abnormality'] ?> |
15. Urine: Reaction: = $data['reaction'] ?> |
Albumin: = $data['albumin'] ?> |
Sugar: = $data['sugar'] ?> |
16. Skiagram Of Chest: |
= $data['skiagram_of_chest'] ?> |
17. Any other test considered necessary by the examining authority. |
= $data['any_other_test_considered_necessary_by_the_examining_authority'] ?> |
18. Any opinion of specialist considered necessary. |
= $data['any_opinion_of_specialist_considered_necessary'] ?> |
 ?>) |
PLACE: GHCL LTD SUTRAPADA |
Signature of the examining authority |
NAME:= getFieldFromTable('patient_name', 'patient_master', 'id', $row_med['doc_attend']); ?>
|
DESIGNATION := getFieldFromTable('designation_name', 'designation', 'designation_id', getFieldFromTable('designation_id', 'patient_master', 'id', $row_med['doc_attend'])); ?>
|
CITY / TOWN : = getFieldFromTable('village', 'patient_master', 'id', $row_med['doc_attend']); ?>
|
DISTRICT : = getFieldFromTable('district', 'patient_master', 'id', $row_med['doc_attend']); ?>
|
PH / MOB: = getFieldFromTable('primary_phone', 'patient_master', 'id', $row_med['doc_attend']); ?>
|
EMAIL ADDRESS: = getFieldFromTable('offial_email_id', 'patient_master', 'id', $row_med['doc_attend']); ?>
|
PLACE OF POSTING : = getFieldFromTable('post', 'patient_master', 'id', $row_med['doc_attend']); ?> |
PO. : SUTRAPADA STATE: = getFieldFromTable('state', 'patient_master', 'id', $row_med['doc_attend']); ?> |
Parameters |
Predicted Value |
Performed Value |
% Of Predicted |
Forced Vital Capacity (FEV) |
= $data['forced_vital_capacity_fev_predicted_value'] ?> |
= $data['forced_vital_capacity_fev_parformed_value'] ?> |
= $data['forced_vital_capacity_of_predicted'] ?> |
Forced Vital Capacity FEV1 |
= $data['forced_vital_capacity1_predicted_value'] ?> |
= $data['forced_vital_capacity1_fev1_parformed_value'] ?> |
= $data['forced_vital_capacity1_fev1_of_predicted'] ?> |
FEV1/FVC |
= $data['fev_fvc_predicted_value'] ?> |
= $data['fev_fvc_parformed_value'] ?> |
= $data['fev_fvc_of_predicted'] ?> |
Peak expiratory flow |
= $data['peak_expiratory_flow_predicted_value'] ?> |
= $data['peak_expiratory_flow_parformed_value'] ?> |
= $data['peak_expiratory_flow_of_predicted'] ?> |