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    Medical Assessment Form: Type: Group A

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    Syahrurrahman Bokow
    Muhammad Taufik is a driver who underwent a periodic medical examination on October 3, 2013. The examination found him to be in normal condition based on his medical history, physical examination, laboratory tests, chest x-ray, spirometry, ECG, and audiometry. The doctor concluded Muhammad was fit for work but recommended he reduce smoking.

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    Medical Assessment Form: Type: Group A

    Uploaded by

    Syahrurrahman Bokow
    10 views1 page
    Muhammad Taufik is a driver who underwent a periodic medical examination on October 3, 2013. The examination found him to be in normal condition based on his medical history, physical examination, laboratory tests, chest x-ray, spirometry, ECG, and audiometry. The doctor concluded Muhammad was fit for work but recommended he reduce smoking.

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    Original Title

    Muhammad Taufik (PBK)

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    Muhammad Taufik is a driver who underwent a periodic medical examination on October 3, 2013. The examination found him to be in normal condition based on his medical history, physical examination, laboratory tests, chest x-ray, spirometry, ECG, and audiometry. The doctor concluded Muhammad was fit for work but recommended he reduce smoking.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    10 views1 page

    Medical Assessment Form: Type: Group A

    Uploaded by

    Syahrurrahman Bokow
    Muhammad Taufik is a driver who underwent a periodic medical examination on October 3, 2013. The examination found him to be in normal condition based on his medical history, physical examination, laboratory tests, chest x-ray, spirometry, ECG, and audiometry. The doctor concluded Muhammad was fit for work but recommended he reduce smoking.

    Copyright:

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    of 1

    Page 1 , No:

    25

    MEDICAL ASSESSMENT FORM


    Type :
    Name Job :
    Muhammad Taufik

    Group A
    File No / Cd : Company :
    25 PBK / BOHC-13 / / 162.5 New

    : Driver

    ASSESSMENT FINDINGS AND ACTION PLAN


    Previous Medical Examinations (Incl. Pre employment, Preplacement and periodic Medical Examination)

    Year Conclusion Medical History and General Information

    Recommendation Physical Examination

    NORMAL CONDITION Laboratorium

    NORMAL CONDITION

    NORMAL CONDITION

    None

    Chest X ray WITHIN NORMAL VALUE Spirometry Conclusion

    ECG NORMAL CONDITION Audiometry Recommendation / Comment Kurangi Merokok

    FIT

    Doctor dr. Syahrurrahman

    Signature

    Date October 3, 2013

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