| Date: |
{{ current_date|date:"d,m,Y" }} |
| MR No: |
{{ report_data.clientObject.MR_NO }} |
| Name: |
{{ report_data.clientObject.name }} |
| Gender: |
{{ report_data.clientObject.gender }} |
| CNIC: |
{{ report_data.clientObject.cnic }} |
| Marital Status: |
{{ report_data.clientObject.Maritial_Status }} |
| Country to Visit: |
{{ report_data.clientObject.country }} |
| Refered By: |
{{ report_data.clientObject.agency.panelName }} |
| Spec. Received: |
{{ report_data.clientObject.specs_recieved }} |
|
| Time: |
{{ current_time }} |
| Lab No: |
{{ report_data.clientObject.Lab_NO }} |
|
{% if report_data.clientObject.relation == 'Father' %}
Father Name:
{% elif report_data.clientObject.relation == 'Husband' %}
Husband Name:
{% endif %}
|
{{ report_data.clientObject.fathernName }} |
| Date of Birth: |
{{ report_data.clientObject.dob }} |
| Passport No: |
{{ report_data.clientObject.passport_no }} |
| Nationality: |
{{ report_data.clientObject.nationality }} |
| Trade: |
{{ report_data.clientObject.Trade }} |
| Height: |
{{ report_data.clientObject.height }} {{ report_data.clientObject.heightUnit }} |
| Weight: |
{{ report_data.clientObject.weight }} {{ report_data.clientObject.weightUnit }} |
|
{% if client_image_base64 %}
{% else %}
No Image
{% endif %}
|
Pre Medical Assessment Report
| History of Candidate |
General Physical Examination |
| (About any Present or Past Illness) |
Result |
| Diabetes |
{{ report_data.diabetes|default:"N/A" }} |
| Asthma |
{{ report_data.asthma|default:"N/A" }} |
| Allergy |
{{ report_data.allergy|default:"N/A" }} |
| Psychiatric |
{{ report_data.psychiatric|default:"N/A" }} |
|
| Type of Examination |
Type of Examination |
| Vision (Both) |
{{ report_data.visionBoth|default:"N/A" }} |
| Color Vision |
{{ report_data.colorVision|default:"N/A" }} |
| Hearing |
{{ report_data.hearing|default:"N/A" }} |
| Liver |
{{ report_data.liver|default:"N/A" }} |
| Skin |
{{ report_data.skin|default:"N/A" }} |
| BP |
{{ report_data.BP|default:"N/A" }} |
|
| Pulse |
{{ report_data.pulse|default:"N/A" }} |
| Heart Beat |
{{ report_data.heartBeat|default:"N/A" }} |
| Lungs |
{{ report_data.lungs|default:"N/A" }} |
| Hernia |
{{ report_data.hernia|default:"N/A" }} |
| Kidneys |
{{ report_data.kidney|default:"N/A" }} |
|
|
Lab Investigations:
| HEMATOLOGY AND CHEMISTRY |
SEROLOGY AND VENEREAL DISEASES |
| HB |
{{ report_data.HB }} {{ report_data.HBunits }} |
| ALT |
{{ report_data.ALT }} {{ report_data.ALTunits }} |
| AST |
{{ report_data.AST }} {{ report_data.ASTunits }} |
| UREA |
{{ report_data.urea }} {{ report_data.ureaunits }} |
| BSR |
{{ report_data.BSR }} {{ report_data.BSRunits }} |
| Creatinine |
{{ report_data.creatinine }} {{ report_data.creatinineUnits }} |
| Bilirubin |
{{ report_data.bilirubin }} {{ report_data.bilirubinUnits }} |
|
| Anti HCV |
{{report_data.antiHCV|default:"N/A"}} |
| HbsAg |
{{report_data.HbsAg|default:"N/A"}} |
| HIV |
{{report_data.HIV|default:"N/A"}} |
| VDRL |
{{report_data.VDRL|default:"N/A"}} |
| Tuberculosis |
{{report_data.tuberculosis|default:"N/A"}} |
| Blood Group |
{{report_data.bloodGroup|default:"N/A"}} |
|
| URINE FOR DRUGS OF ABUSE |
| Amphetamine |
{{ report_data.amphetamine|default:"N/A" }} |
| Benzodiazepine |
{{ report_data.benzodiazepine|default:"N/A" }} |
| Marijuana |
{{ report_data.marijuana|default:"N/A" }} |
| Anti-Depressant |
{{ report_data.antiDepressant|default:"N/A" }} |
|
| Barbiturate |
{{ report_data.Barbiturate|default:"N/A" }} |
| Cocaine |
{{ report_data.cocaine|default:"N/A" }} |
| Methadone |
{{ report_data.methadone|default:"N/A" }} |
| Phencyclidine |
{{ report_data.phencyclidine|default:"N/A" }} |
|
| X-RAY CHEST |
| X-RAY CHEST (PIA VIEW) |
{% if report_data.chestXray == 'Normal' %}
{{ report_data.chestXray|default:"N/A" }}
{% elif report_data.chestXray == 'Abnormal' %}
{{ report_data.chestXray|default:"N/A" }}
{% else %}
{{ report_data.chestXray|default:"N/A" }}
{% endif %}
|
| Details |
{{ report_data.chestXrayDescription|default:"" }}
|
|
The examinee is medically {{ report_data.fitnessStatus }} for employment where it may be concerned.
Not valid for court. The report is acceptable for only 60 days.
Electronically verified. No signature(s) required.
|
{% if report_data.fitnessStatus == 'FIT' %}
{% elif report_data.fitnessStatus == 'UNFIT' %}
{% endif %}
|
|
{% if report_data.doctors.all.exists %}
{% for doctor in report_data.doctors.all %}
{{ doctor.doctorName }}
{{ doctor.doctorEducation }}
|
{% if forloop.counter|divisibleby:4 and not forloop.last %}
{% endif %}
{% endfor %}
{% endif %}