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Drug Screening Form
Drug Screening Form
Garments Division
Korardi, Shibpur, Narsingdi-1600, Bangladesh
1. Name
2. Father’s Name 3. Mothers’ Name
4. Spouse’s Name
5. Present Address :
6. Age: 7. Height 8. Weight
Date :
If any body is addicted to drug or alcohol then the following symptoms are shown.
DOCTOR’S COMMENTS
Based on above findings this person is free from drug abuse: a) She/he is fit for work
b) She/he is not fit for work