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  • GCC Medical Form

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    தஞ்சை செல்வம்
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    This form is for a medical checkup required for a work visa in Bahrain. It collects personal information like name, age, nationality, passport number, and job title. It records vital health data such as blood pressure, height, weight, and vision test results. It includes a clinical examination section to note any issues found for cardiovascular, respiratory, and general health. It lists various lab tests to be performed including stool, blood, and serology tests. At the end, the examining doctor must declare the information is true and release it to authorities, and the individual agrees to this as well.

    Original Description:

    Medical form Bahrain

    Original Title

    GCC medical form

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    This form is for a medical checkup required for a work visa in Bahrain. It collects personal information like name, age, nationality, passport number, and job title. It records vital health data such as blood pressure, height, weight, and vision test results. It includes a clinical examination section to note any issues found for cardiovascular, respiratory, and general health. It lists various lab tests to be performed including stool, blood, and serology tests. At the end, the examining doctor must declare the information is true and release it to authorities, and the individual agrees to this as well.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    2K views1 page

    GCC Medical Form

    Uploaded by

    தஞ்சை செல்வம்
    This form is for a medical checkup required for a work visa in Bahrain. It collects personal information like name, age, nationality, passport number, and job title. It records vital health data such as blood pressure, height, weight, and vision test results. It includes a clinical examination section to note any issues found for cardiovascular, respiratory, and general health. It lists various lab tests to be performed including stool, blood, and serology tests. At the end, the examining doctor must declare the information is true and release it to authorities, and the individual agrees to this as well.

    Copyright:

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

    Kingdom of Bahrain 

    Ministry of Health 


    Primary care & public health 
    This form is applicable in countries with no GCC accredited medical center
    Medical checkup requirement for permission work visa in kingdom of Bahrain
    SECTION1: Personal Data
    Name Age

    Nationality Passport No.

    Photo DOB SEX

    Marital status married single divorced widow

    CPR/IF applicable JOB Title

    SECTION 2 : Vital Data

    blood pressure / Hight Kg ECG normal abnormal

    coloure vision normal abnormal


    pulse regular irregular Weight Cm
    vision RT /6 LT /6

    SECTION3: Clinical Examination/Lab Investigation


    Clinical Examination

    Cardiovascular Examination Respiratory Examination

    General appearance N AB Ascultation N AB


    Auscultation N AB Chest x-ray N AB

    note:

    Labratory Investigation Serology RESULT Fit UNFIT


    Result
    Hospital Stamp
    Stool HBsAg Negative Positive
    Normal Ubnormal HCV Negative Positive
    OVA HIV Negative Positive
    CYST VDRL Negative Positive
    Amoebae URNE
    Flagyal Sugar
    RBC Albumin
    WBC Blood

    DECLERATION

    I hereby have no objection to release any information content in this requst to the concerned
    authority.

    I Dr declare that all information given is true.

    Signature Date

    *kindly refer to the pre-employment examination general rules for expatriates www.lmra.bh
    *Polio vaccination mandatory in reported country /MMR is must for expatriates from endemic area.

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