Dehradun Boys School Name | sroroncese Date of Birth Medical Record Update House/Roll number Dehradun Boys School tries to provide the best possible care for its students while they are at school. Please assist us in keeping your son safe by providing full and accurate information about his health during the holidays so that we may keep our records current, Yes No. Did your son have any illness while on holid: Is your son suffering from any infectious disease at present? Has there been any change in his health status while on holiday? Has he been given any vaccinations while on holiday? Has he been started on any long-term medic Has any family member had typhoid or hepatitis in the months? oO Was there an illness or death in the family during the last three months? oO oO oO Was there a major change in family circumstances’ in the last three months? Please give details if you have answered any of these questions in the affirmative. If your son had an illness for which he needed to see a doctor, or had any investigations done, please attach copies of relevant records. below. If there is anything NEW about your child that you would like us to know please tell us in the box 1. Includes having been prescribed glasses, contact lenses, or other aids and appliances. 2. Including a move, separation or divorce. PLEASE complete this form and return it to the school BEFOREDehradun Boys School Name | vcs seein Date of Birth Medical Record Update House/Roll number : I declare that my son/ ward is not suffering from any illness that would constitute a risk to himself or to others while he is at school, and that the Information I have given in this form is complete and accurate to the best of my knowledge and belief Name Signature Relationship (specify mother, father or legal guardian) Date