VEDANTA LIMITED JHARSUGUDA, FORM NO.31-A MEDICAL EXAMINATION REPORT (PERLODICAL / RREEMPLOVMENT MEDICAL EXAMINATION) 1. Name of the Factory/ Contractor Agency 2. Name of the Employee Employees distinguish number Age of the employee Identification Mark |. Date of Employment. . Length of services in years 1. General Survey 10, Blood Group & Rh Typing 11, EYEVISION Use of glass 12. Hearing ‘Audiometry 13. Respiratory System ‘And Chest Measurement Spirometry 14. CARDIVASCULAR SYSTEM ECG 3 4 s. 6. Nature of the job (Designation & Department): 2. 8, 9. Mesuvbiss Tnolfa iH . Los ey Alatoyonn— £0. P-1) p- ¢ 2OF . |) 20a LA fea) : Heath; G64 Fair/ Poor Height:_1.G |_cm ae —f re lok umraye ac | NONGAY/ ABNORMAL Les NO iva 6 ree C ce ine G ren Le | OV: NORMATABNORMAL Nort Abnormal = re t4 0 15 ou Expiration _&°G cms Respiratory Rate_Q\_ / Minute 1 Type of Respiration + Remarks if any. t FNC: VO REV I/FVC:_ 108% :putse:_83 pme Bp 193/85 mmug HEART SOUND: Abnwmol 1 f.2°4 ccurre " REMARKS IF ANY: YES/ NQ—— si : : NQBMAL/ ABNORMAL15, ABDOMINAL TENDERNESS LIVER SPLEEN 16, NERVOUS SYSTEM HasToRy OF FITS EPuErSY REMARK ON NU NTAL HEALTH 47, t0cOMOTOR SYSTEM 18, SKIN CONDITION [REMARK ON ANY SKIN DISEASE NOTICED 19. HERNIAS 20. HYDROCELE 21, PRESENT COMPLAINS IF ANY 22. SUMMARY OF FINDINGS HEART DISEASES HYPERTENSION DIABETES TUBERCULOSIS EPILEPSY SYES/ WO, NORMAL ABNORMAL EMORIARL/ ARMOBIAAL ves No 7 : YESNO~ +6907 POOR s NORMAL/ABNORMAL LNORAAL/ABNORMAL FYES/ WO = PRESENT/ABSENT ~~ : PRESENT/ABSENT ~~