Scribd Logo
Upload

Welcome to Scribd!

  • Form31 A

    Uploaded by

    Priyanka Dad
    217 views2 pages
    This document is a health record form used for pre-employment or periodic employee health assessments. It collects information such as the employee's name, age, job details, blood group, vision, hearing, respiratory rate, cardiovascular exam, abdominal exam, neurological exam, skin exam, and summaries any present health complaints, findings such as heart disease, hypertension, diabetes, tuberculosis, epilepsy or occupational diseases, and recommendations for further investigations.

    Original Description:

    Original Title

    form31-A

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document is a health record form used for pre-employment or periodic employee health assessments. It collects information such as the employee's name, age, job details, blood group, vision, hearing, respiratory rate, cardiovascular exam, abdominal exam, neurological exam, skin exam, and summaries any present health complaints, findings such as heart disease, hypertension, diabetes, tuberculosis, epilepsy or occupational diseases, and recommendations for further investigations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    217 views2 pages

    Form31 A

    Uploaded by

    Priyanka Dad
    This document is a health record form used for pre-employment or periodic employee health assessments. It collects information such as the employee's name, age, job details, blood group, vision, hearing, respiratory rate, cardiovascular exam, abdominal exam, neurological exam, skin exam, and summaries any present health complaints, findings such as heart disease, hypertension, diabetes, tuberculosis, epilepsy or occupational diseases, and recommendations for further investigations.

    Copyright:

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

    Form No-31-A HEALTH RECORD

    (Pre-employment/ Periodical)

    [Prescribed under Rule62-I]

    1.Name of the factory :

    2.Name of the Employee :

    3.Employee Distinguishing Number :

    4.Age of the employee :

    Identification mark :

    Nature of job

    5.Date of Employment :

    6.lenght of service in years :

    7.General Survey

    Health :- Good/Fair/Poor Height:- Cms.

    Weight :- Kg

    8.Blood Group

    9.Eye Vision

    Normal/Abnormal Use of glass: Yes/No

    10.Hearing: Normal/Abnormal

    11.Respiratory System and Chest Measurement

    Inspiration Expiration

    Respiration /min Remark , if any

    12.Cardiovasular system

    Pulse Rate B.P

    Heart Sound Remark , if any

    13.Abdomen Tenderness: Yes/No

    14.Norvous system.

    History of fit: Yes/NO

    Epilepsy: Yes/NO

    15.Locomotors System: Normal/Abnormal

    16.Skin condition: Normal/Abnormal

    Remark on any skin Disease Notice:-

    17.Hernias:Present/Absent

    18.Hydrocele: Present/Absent

    19.Present Complain, if any

    20.Summery of Findings:

    Heart Disease Hypertension

    Diabetes T.B

    Epilepsy Poisoning

    Others Occupational disease, if any

    21.Recommedation , if any

    For any further investigation.

    You might also like