VEDANTA LIMITED THARSUGUDA, FORM NO.31-A MEDICAL EXAMINATION REPORT (PERLODICAL / PREEMPLOYMENT MEDICAL EXAMINATION) Name of the Factory/ Contractor Agency Name of the Employee Employees distinguish number ‘Age of the employee Identification Mark 1 2 3 4, s, 6. Nature of the job (Designation & Department): 7, 8 9. . Date of Employment . Length of services in years 5 1. General Survey : Health: Good/ Fair/ Poor Height: "YO cm Weight: G2 Ke, ow:> _x¢ 10, Blood Group & Rh Typing :B4ve 11, EYE VISION NORMAL ABNORMAL Use of glass + YES/, pO wag Crees C ce cw Grew ve + 0V: MORMTAL/ABNORMAL 12. Hearing = Nosmsl/ Abnormal ‘Audiometry :Le_)4 pee 14 DB 13, Respiratory System Inspiration, q 5 ems And Chest Measurement + Expiration oO ems Respiratory Rate_| 8 _/ Minute 1 Type of Respiration, + Remarks if any Spirometry z#vc: 104%, revasevcs 9 14, CARDIVASCULAR SYSTEM :PULse:_TA fone sp 130/29. - tr smo A sta oA srg REMARKS IF ANY: YES/NO | NORMAL ABNORMAL15, ABDOMINAL TENDERNESS YES/NO uver i SPLEEN ss ny ‘ABNORMAL 16, NERVOUS SYSTEM RORMIAL ABNORMAL HISTORY OF FITS ; SYES/ Hi EPILEPSY to" REMARK ON MENTAL HEALTH. 2 = +8006/ Poor 17, LOCOMOTOR SYSTEM, Pa PNORMAL/Aa 18. SKIN CONDITION e NORMAL, ‘REMARK ON ANY SKIN DISEASE Ni ; NORNAAL/ABNORNAAL ‘YES/NO, 19. HERNIAS 0 No 20, HYDROCELE , | PRESENT ABSENT —