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Medical Fitness Certificate Report

Mr. Jyotirmoy Pathak, 27 years old, underwent a medical examination on January 17, 2021. [1] He was found to be in good health with normal vital signs, hearing, vision, neurological functions, and laboratory test results. [2] He was declared physically fit for working at heights. [3] The examining doctor noted no signs of illness or medical conditions that would prevent employment.

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Pankaj Maithani
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122 views3 pages

Medical Fitness Certificate Report

Mr. Jyotirmoy Pathak, 27 years old, underwent a medical examination on January 17, 2021. [1] He was found to be in good health with normal vital signs, hearing, vision, neurological functions, and laboratory test results. [2] He was declared physically fit for working at heights. [3] The examining doctor noted no signs of illness or medical conditions that would prevent employment.

Uploaded by

Pankaj Maithani
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Certification No : Medi-18-30378

Company Name : Ceragon India Pvt.Ltd. Reg.Number : 30378


Patient Name : Mr. JYOTIRMOY PATHAK Check-UP-Date: 17.01.2021
Designation : Joining Date :
Emp Code : D. O. B. :
Cont. Name : Age /Sex : 27 MALE
Company Add. : GUWAHATI Blood Group : O+VE
Certification No : Medi-18-30378 Identify Mark: Nil
Part 2 - Clinical Examination/ Lab test
1 Cardiovascular system BMI 20
Height 160 cm. Weight 51 Kg.
2 Blood pressure - (repeat if necessary)
Systolic / Diastolic 120 / 80 mmHg -
B. Pulse rate Regular 72 Irregular -
C. Heart sounds Normal √ Abnormal -
D. Peripheral pulses Normal √ Abnormal -
3. Chest/Lungs Normal √ Abnormal -
4. Abdomen (Liver) Normal √ Abnormal -
5. Neurological/Locomotor
A. Cervical spine rotation Normal √ Abnormal -
B. Back movement Normal √ Abnormal -
C. Upper limbs
Appearance Normal √ Abnormal -
Joint movements Normal √ Abnormal -
D. Lower limbs
Appearance Normal √ Abnormal -
Joint movements Normal √ Abnormal -
E. Reflexes Normal √ Abnormal -

F. Romberg’s sign Normal √ Abnormal -

A pass requires the ability to maintain balance while standing with shoes off, feet together side by side, eyes closed
and arms by sides, for 30 seconds

6. Hearing (Doctor's judgement) Normal √ Abnormal -

7. Vision Test (Doctor's judgement) NORMAL


8. Routine Urine Examination Albumin - Absent Sugar - Absent
:
9. Routine Blood examination HAEMOGRAM -
Blood Group - O+VE Hb % - 13.6
RBC - 4.59 TLC - 6800
999
Blood Sugar - 88 Platelets Count- 2.45 L/C
DLC- P : L: E: M: 000 B :
59 36 3 2 0
Sr. Cholesterol - 130 mg/dl S/Triglycerides - 128 mg/dl
HDL - 32 mg/dl LDL - 126 mg/dl

FOR MEDI-CHECK
Health Services Pvt. Ltd
Part 3- Certificate of Physical fitness

I hereby certify that Mr. JYOTIRMOY PATHAK

has been examined by us, we cannot discover that he / she has got any disease,

communicable or otherwise, constitutional or bodily deformity except N.A. …………...

Candidate is hereby declared,

√ - -
FIT UNFIT TEMPORARILY UNFIT

for the post of


1) Working on Height - √
2) Electrical work - -
3) Material lifting - -
4) Four wheeler Driving - -

Vertigo Test - No Giddiness, No any other Abnormality seen during test.

Doctor’s full name - Dr. Pradeep V. Mahajan


Seal & Signature -
Registration number - 53369
Date of examination 17.01.2021

FOR MEDI-CHECK
Health Services Pvt. Ltd

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