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    N.K.Bagrodia Public School Sec-IV, Dwarka

    Uploaded by

    Shishupal Choudhary
    This document contains a school health record and medical checkup form for a student. It includes information such as the student's name, date of birth, admission number, parents' names and contact details. It also has sections for recording vaccinations received and dates as well as noting any allergies or health issues. The medical checkup section gathers information on the student's general appearance, vital signs, oral examination, ear/eye examination, and musculoskeletal system with the doctor providing an assessment of their current health and any recommendations.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    N.K.Bagrodia Public School Sec-IV, Dwarka

    Uploaded by

    Shishupal Choudhary
    25 views5 pages
    This document contains a school health record and medical checkup form for a student. It includes information such as the student's name, date of birth, admission number, parents' names and contact details. It also has sections for recording vaccinations received and dates as well as noting any allergies or health issues. The medical checkup section gathers information on the student's general appearance, vital signs, oral examination, ear/eye examination, and musculoskeletal system with the doctor providing an assessment of their current health and any recommendations.

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    Health Card.docx

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    This document contains a school health record and medical checkup form for a student. It includes information such as the student's name, date of birth, admission number, parents' names and contact details. It also has sections for recording vaccinations received and dates as well as noting any allergies or health issues. The medical checkup section gathers information on the student's general appearance, vital signs, oral examination, ear/eye examination, and musculoskeletal system with the doctor providing an assessment of their current health and any recommendations.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    25 views5 pages

    N.K.Bagrodia Public School Sec-IV, Dwarka

    Uploaded by

    Shishupal Choudhary
    This document contains a school health record and medical checkup form for a student. It includes information such as the student's name, date of birth, admission number, parents' names and contact details. It also has sections for recording vaccinations received and dates as well as noting any allergies or health issues. The medical checkup section gathers information on the student's general appearance, vital signs, oral examination, ear/eye examination, and musculoskeletal system with the doctor providing an assessment of their current health and any recommendations.

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    © All Rights Reserved
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    N.K.

    Bagrodia Public School


    Sec-IV, Dwarka
    SCHOOL HEALTH RECORD
    General Information

    Name:

    .
    Date of Birth:
    .

    Admn. No.:

    Fathers/Guardians Name & Address:

    ..

    ..

    ..

    Name of the
    Student..M/F..Class
    . Date of Birth
    Blood Group
    ........ Fathers Name
    Mothers Name
    ............

    VACCINATION
    IMMUNIZATION
    BCG
    Hepatitis B
    DPT
    HB
    Oral Polio

    Measles
    MMR
    DPT+OPV+HIB
    Typhoid
    Hepatitis A(2 doses)
    Chicken Pox
    DT-OPA

    AGE
    RECOMMEND
    ED
    0-1 Month
    At Birth
    1 Month
    6 Month
    2 Months
    3 Months
    4 Months
    2 Months
    3 Months
    4 Months
    At Birth
    1 Months
    2 Months
    3 Months
    4 Months
    9 Months
    16 Months
    18 Months
    2Years
    2 Years
    After age 1
    Year
    4 Year

    DUE DATE

    BOOSTER DOSES
    Typhoid (every 3

    DATE

    years)
    TT(every 5 years)
    Other Vaccines

    Signature of the Father ... Signature of the


    Mother

    N.K.Bagrodia Public School,


    Dwarka
    STUDENT GENERAL MEDICAL CHECK UP

    HEALTH HISTORY
    ALLERGY TO ANY FOOD, ADHESIVE TAPE, BEE
    STING
    Allergy

    What
    Happened

    How Severe

    Medication taken at the


    Time of Allergy

    * Does the child have any problem during physical


    activity___________________
    Signature of the Father _______________ Signature of the
    Mother____________

    To be certified by a Registered Medical Practitioner


    Date of physical examination.. Height
    .. Weight
    B.P. . Pulse Vision L
    ...... R.
    Squint . Conjunctiva .. Cornea Ear L
    . R.
    Clinical Examination

    Normal

    Recommendation

    Head /Neck
    Abdomen
    Surgery
    Serious Illness
    Nails
    Skin
    Summary of Current health condition,
    ___________________________________
    __________________________________________________________________
    _
    __________________________________________________________________
    _
    Fit to Participate in age specific physical activity

    Fit to Participate in age specific physical activity with


    precaution ..

    .
    Should not Participate in competitive sport
    ..
    Name of the Doctor .
    Doctor
    ..
    General Appearance
    Weight Kg.
    Actual
    Percentile
    Height Cms Actual
    Percentile
    Eye Vision
    R.E
    L.E.
    Squint
    Conjunctiva
    Cornea
    Rt. Lt.
    Ears:
    External Ear
    Middle Ear
    ORAL CAVITY
    GUMS
    Colour

    Signature of the

    Teeth Occlusion
    Caries
    TONSILS
    Lymph Nodes
    Pulse
    B.P.
    Nails
    Skin
    Muscle, Skeletal
    System/Knee/Flat Feet/
    Lordosis/Kyphosis
    Systemic Examiation

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