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  • Physical Assessment

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    Argie Joy Marie Ampol
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    This document is a school health examination form. It collects information such as the student's name, date of birth, parent/guardian details, and address. It includes a table to record examination findings and interventions for temperature, blood pressure, height, weight, visual acuity, hearing, and other physical attributes on dates ranging from the 7th month to the 12th month. The form also includes sections to note and classify examination results for the skin/scalp, eyes/ears/nose, mouth/throat/neck, lungs/heart, abdomen/genitalia, spine/extremities, and remarks or required interventions.

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    physical assessment

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    This document is a school health examination form. It collects information such as the student's name, date of birth, parent/guardian details, and address. It includes a table to record examination findings and interventions for temperature, blood pressure, height, weight, visual acuity, hearing, and other physical attributes on dates ranging from the 7th month to the 12th month. The form also includes sections to note and classify examination results for the skin/scalp, eyes/ears/nose, mouth/throat/neck, lungs/heart, abdomen/genitalia, spine/extremities, and remarks or required interventions.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    16 views4 pages

    Physical Assessment

    Uploaded by

    Argie Joy Marie Ampol
    This document is a school health examination form. It collects information such as the student's name, date of birth, parent/guardian details, and address. It includes a table to record examination findings and interventions for temperature, blood pressure, height, weight, visual acuity, hearing, and other physical attributes on dates ranging from the 7th month to the 12th month. The form also includes sections to note and classify examination results for the skin/scalp, eyes/ears/nose, mouth/throat/neck, lungs/heart, abdomen/genitalia, spine/extremities, and remarks or required interventions.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 4

    SCHOOL HEALTH EXAMINATION FORM

    NAME_______________________________________ Division________________________
    Last First Middle Telephone No.___________________
    Date of Birth __________________________________
    Month Day Year
    Birthplace____________________________________
    Parent/Guardian______________________________
    Address______________________________________

    Date of Examination 7 8 9 10 11 12
    Findings

    Intervention

    Findings

    Intervention

    Findings

    Intervention

    Findings

    Intervention

    Findings

    Intervention

    Findings

    Intervention
    Temerature
    Blood Pressure
    Heart Rate/Pulse/Respiratory
    Height
    weight
    Nutritional Status
    Visual Acuity (Snellen's)
    Hearing (Tunning Fork)
    Skin/Scalp
    Eyes/Ears/Nose
    Mouth/Throat/Neck
    Abdomen/Genitalia
    Spine/Extremities
    Others, specify
    Examied by
    Abdomen/ Spine/
    NS skin/Scalp Eye/Ear/Nose Mouth/Neck/Throat Lungs/Heart
    Genitalia Extremities
    a. Normal a. Normal a. Normal Eye
    b. Below
    Normal b. Pediculosis b. Normal Ears
    c. Above
    Normal c. Tinea Flava c. Normal Nose
    d. Ringworm d. Squinting
    e. Eczema e. Pale conjunctivae
    f. Impetigo/boil f. ear discharge
    g. Hematoma g. impacted cerumen
    h. Bruises h. Septal Deviation
    i. Cuts/Lacerations i. Nasal Discharge
    j. allergy j. others, specify
    k. others, specify
    Remarks/
    Intervention

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