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  • Borang Pengesahan Kesihatan Murid

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    421 views1 page

    Borang Pengesahan Kesihatan Murid

    Uploaded by

    azyana88

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    Borang Pengesahan Kesihatan Murid

    Adakah anak /jagaan tuan/puan mengidap penyakit berikut ?

    1. Penyakit kulit berjangkit : .[ ada / tiada ]


    2. Lelah /semput : ..[ ada / tiada ]
    3. Sawan : ..[ ada / tiada ]
    4. Buah pinggang : ..[ ada / tiada ]
    5. Lemah jantung : ..[ ada / tiada ]
    6. Penyakit-penyakit lain (jika ada):
    (Nyatakan penyakit)
    7. Alahan ubat : .(sila
    nyatakan)
    8. Alahan makanan : . (sila
    nyatakan)

    Saya .ibu bapa / penjaga


    kepada pelajar bernama ...dengan ini mengesahkan
    bahawa segala maklumat di atas adalah benar.

    Tandatangan : .. Tarikh :

    Nama : .

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