Health Screen Entry
 

Height cm Weight kg
BMI Rate per Minute
Character Normal   Abnormal
BloodPressure mm hg
Breast Examination
Breast Examination Normal Abnormal
Comments

Genital System
Genital System
Normal   Abnormal
Comments


Abdominal Examination
Liver Enlargement Yes NO
Spleen Enlargement Yes NO
Comments
Abdominal Mass Yes NO
Herinial Yes NO

Central Nervous System
Reflexes Yes NO
Motor Power Yes NO
Gait Yes NO
Comments


Respiratory System
Expansion Of Chest Yes     NO
Percussion Yes NO
Comments
Ascultation Yes NO

Cardio Vascular System
Heart Sounds Yes NO
Rhythm Yes NO
Comments
Presence Of Murmor Yes NO

ENT
Any Abnormalities Yes NO
Comments



Eye Examination
  Type Right Left
xxx xxx xxx
Comments