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] Frequency [Hz]

125 250 500 1k 2k 4k 8k 125 250 500 1k 2k 4k 8k

-10 -10

0 0

10 10

20 20

30 30
Slight/mild Slight/mild
Hearing Level [dB]

Hearing Level [dB]

40 40

50 50
Moderate* Moderate*
60 60

70 70
Severe Severe
80 80

90 90

100 100
Profound Profound
110 110

120 120

AC NR AC NR

Device: MA 25e Serial number: MA9079824

Notes:

Signature:

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