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Student Health Card

The document is a Student Health Card that requires parents or guardians to fill in essential information about the student, including personal details, health conditions, and emergency contacts. It also includes guidelines for managing contagious diseases and consents for medical attention. Parents must sign to acknowledge their understanding of the school's medical treatment policies and potential costs involved.

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merlin vista
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300 views1 page

Student Health Card

The document is a Student Health Card that requires parents or guardians to fill in essential information about the student, including personal details, health conditions, and emergency contacts. It also includes guidelines for managing contagious diseases and consents for medical attention. Parents must sign to acknowledge their understanding of the school's medical treatment policies and potential costs involved.

Uploaded by

merlin vista
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

STUDENT HEALTH CARD

As per the guidelines of Ministry of Health’s Student’s copy


(To be filed in by the Parent / Guardian in Capitals)
Student’s Full Name
Nationality
CPR No :
Height : Weight : Grade :
Guardian Phone No
Emergency Contact No
Student’s Health Centre
Please Put ( ) as applicable
Disease Name Disease Name Disease Name
Digestive System Disease Sickle Cell Anemia Heart Disease
Urinary Tract Diseases Thalassemia Chest / Respiratory Diseases
Spinal Problems (G6PD) Difficulty in pronunciation
Dental Problems Endocrine Diseases Diabetes
Psychiatric Illness Allergic Eczema Epilepsy
Physical Disabilities Visual Impairment Cerebral Palsy
Malnutrition / Overweight/ Hearing Impairment Iron Anemia
Underweight
Other diseases not mentioned or drug allergy
Treatment
Consultants Name
Is the student using any of the devices mentioned below. Please tick ( ) as applicable
Other: Wheelchair Hearing Aids Medical Glasses
Note :
Please attach a medical report from the consultant doctor showing the health status of the
student in case of chronic diseases like diabetes, EPile PM
It is our responsibility to adhere to certain guidelines when we are affected by any contagious
disease, to curtail spreading of the same:
Chicken Pox -10 days (from onset of rashes)
Measles -10 days ( from day of confirmation)
Hand, Foot and Mouth disease – 5 days
Conjunctivitis – 5 days
MMR - 9 days from onset
Consents for Medical Attention
I abide by the school rules that in case my child / ward needs medical treatment or in case
of medical emergency the school will provide first aid and will communicate to the parent
to take the child from school and arrange for further medical treatment if required.
I also under take to pay any costs which may be incurred for the medical treatment,
ambulance, transport and drugs.

Parent’s Signature ______________________ Date _________________

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