Patient: anto Session date: 06/03/2023 16:57

Date of birth:
ID:

Tone Audiometry
Grades of hearing loss based on WHO recommendation (*In case of moderate hearing loss, the range for children is from 31-60 dB)
Right Ear Left Ear
Frequency [Hz] 1252505001k2k
Frequency [Hz] 1252505001k2k
4k 8k 4k 8k

-10 -10
0 0
10 10
20 20
30 30
40 40
50 50
60 Slight/mild 60 Slight/mild
Hearing Level [dB]

Hearing Level [dB]

70 70
80 80
90 Moderate* 90 Moderate*
100 100
110 110
120 Severe 120 Severe

Profound Profound

AC NR AC NR

Device: MA 25e Serial number: MA9079824

Notes:

Signature:

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