Gunam Super Speciality Hospital

( A Unit of Hosur super speciality hospitals Pvt.Ltd.)

#35.Tank Street,Opp.Govt.hospital,Hosur-635 109
Mail: marketing@gunamhospital.com. Ph : 04344 - 220599,
+91 80980 55055
ANNUAL HEALTH CHECK UP REPORT- 2022
Name of the Employee :…………………………………………………….. Age : ……….Yrs

Employee ID :………………. Dept. : ………………………………….. Sex :Male / Female

Address : GLOBAL CALCIUM PVT LTD UNIT - 1 & 11 ,
125 &126, Sipcot Industrial Complex ,
Hosur - 635126 .
General & Systemic Examination:
Height : ……….. Cm Weight : ……………. Kgs Temp : ………………….
Pulse : ……….. b/m SpO2 : ……………….% BP : ......…/……..mm/Hg

CVS : S1S2 - GIT : SOFT Skin :

RS : NVBS - CNS : NFND Oral Hygiene:

Lab Investigation:
`ve`
Hb:…………… g/dl RBS : …………….mg/dl B/G :……………

ECG : ………….. PFT: ……………… AUDIOMETRY :…………..

EYE - Rt : ………. Lt ;………………. Colour Vision : ……………..

Past History :

Family History :

Remarks :

I do here by certify that Mr/Mrs …………………………………………………… Employed with

M/s,GLOBAL CALCIUM PVT LTD -Unit 1&11 ,Has been carefully examined by me on / /2022
Based on Reports & Physical examination conducted, He/She is medically FIT/UNFIT to work in
the above mentioned Establishment.

Date : / /2022
Place: Hosur Signature of Doctor
Reg. No. :
Gunam Super Speciality Hospital
( A Unit of Hosur super speciality hospitals Pvt.Ltd.)
#35.Tank Street,Opp.Govt.hospital,Hosur-635 109