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  • Annual Medical Examination Slip

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    Paul Gabriel Bathan
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    This medical examination slip from a school clinic lists the various medical tests and procedures a student will undergo as part of their annual checkup, including color vision, physical examination, urinalysis, blood tests, hearing test, and chest x-ray. The nurse's signature is required to verify completion of each test, and the fully stamped slip will be the student's record of the medical exam results.

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    This medical examination slip from a school clinic lists the various medical tests and procedures a student will undergo as part of their annual checkup, including color vision, physical examination, urinalysis, blood tests, hearing test, and chest x-ray. The nurse's signature is required to verify completion of each test, and the fully stamped slip will be the student's record of the medical exam results.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    18 views1 page

    Annual Medical Examination Slip

    Uploaded by

    Paul Gabriel Bathan
    This medical examination slip from a school clinic lists the various medical tests and procedures a student will undergo as part of their annual checkup, including color vision, physical examination, urinalysis, blood tests, hearing test, and chest x-ray. The nurse's signature is required to verify completion of each test, and the fully stamped slip will be the student's record of the medical exam results.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    _________________________________

    Medical Provider

    SCHOOL CLINIC
    ANNUAL MEDICAL EXAMINATION SLIP

    NAME:______________________ Course/Yr./Sec.:_________
    DATE OF EXAM:_____________________ TIME:____________

    PROCEDURE SIGNATURE
    Ishihara’s Test (Color Vision Test)
    Physical Examination
    Urinalysis (Urine Test)
    Blood Extraction (CBC, HBsAg)
    Audio Test (Hearing Test)
    Chest X-ray
    Present this slip for your medical exam and Keep this for your
    medical result copy.

    School Nurse :_____________________ Date:___________

    Form No. BPM2-CLN 15 001-01


    Rev. 02

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