Date:
{{ current_date }}
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 }}
No image
{% endif %}Pre Medical Assessment Report
| History of Candidate | |
|---|---|
|
(About any Present or Past illness)
Results
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" }}
|
|
| GENERAL PHYSICAL EXAMINATION | |
|
{% if report_data.fitnessStatus == 'FIT' %}
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|default:"N/A" }}
ALT {{report_data.ALT|default:"N/A"}} AST {{report_data.AST|default:"N/A"}} UREA {{report_data.urea|default:"N/A"}} BSR {{report_data.BSR|default:"N/A"}} Creatinine {{report_data.creatinine|default:"N/A"}} Bilirubin {{report_data.bilirubin|default:"N/A"}} |
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): {{ report_data.chestXray|default:"N/A" }} | |
| 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.
{{ doctor.doctorEducation }}