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    Certificate of Physical Fitness: IA. History of Any Known Illness / Surgery

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    The document is a certificate of physical fitness for an applicant named OSSSMS BO HAMD, who is a 33-year-old married Syrian man. After examining the applicant, the medical practitioner found him to be in good health overall with no significant medical issues or communicable diseases. Specifically, the applicant does not have any chronic conditions, illnesses, or physical limitations that would prevent him from fully participating in and completing a university program of study in India.

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    Certificate of Physical Fitness: IA. History of Any Known Illness / Surgery

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    kkkk
    37 views2 pages
    The document is a certificate of physical fitness for an applicant named OSSSMS BO HAMD, who is a 33-year-old married Syrian man. After examining the applicant, the medical practitioner found him to be in good health overall with no significant medical issues or communicable diseases. Specifically, the applicant does not have any chronic conditions, illnesses, or physical limitations that would prevent him from fully participating in and completing a university program of study in India.

    Original Title

    1580849007_Physical_Fitness_Fitness

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    The document is a certificate of physical fitness for an applicant named OSSSMS BO HAMD, who is a 33-year-old married Syrian man. After examining the applicant, the medical practitioner found him to be in good health overall with no significant medical issues or communicable diseases. Specifically, the applicant does not have any chronic conditions, illnesses, or physical limitations that would prevent him from fully participating in and completing a university program of study in India.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views2 pages

    Certificate of Physical Fitness: IA. History of Any Known Illness / Surgery

    Uploaded by

    kkkk
    The document is a certificate of physical fitness for an applicant named OSSSMS BO HAMD, who is a 33-year-old married Syrian man. After examining the applicant, the medical practitioner found him to be in good health overall with no significant medical issues or communicable diseases. Specifically, the applicant does not have any chronic conditions, illnesses, or physical limitations that would prevent him from fully participating in and completing a university program of study in India.

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    CERTIFICATE OF PHYSICAL FITNESS

    (To be filled by a Registered Medical practitioner


    in the applicant’s country of domicile)

    Name of Applicant OSSSMS BO HAMD

    Sex M/F male

    Marital Status Married

    Age 33 Blood Group A+

    Nationality SYRIAN

    Address TARTUS-BANYAS

    (City) TARTUS

    (Country) SYRIA

    Telephone No. +963932892405

    Email Address Malk50000@gmail.com

    I. Medical History (Please give details of any past medical condition which may adversely
    impact the patient’s health at the current time or in the near future).

    IA. History of Any Known Illness / Surgery:-

    Raised BP - Yes No 0 If, yes – on Regular treatment - Yes No

    DM - Yes No 0 If, yes – on Regular treatment - Yes No

    IHD - Yes No 0 If, yes – on Regular treatment - Yes o No

    Stroke - Yes No 0 If, yes – on Regular treatment - Yes o No

    Kidney Disease:

    Chronic Renal Failure – Yes No 0If, yes – on Regular treatment - Yes No

    Any history of Surgery / prolonged hospitalization (more than 2 weeks)

    Yes/No; if yes, details of illness / injury / surgery with duration of illness/ treatment

    Any history of loss of appetite - Yes No 0

    Any history of loss of Weight - Yes No 0

    Any history of digestive diseases - Yes No 0

    Family History of : DM HT Obesity

    Any known Allergy:- If so, is the patient on any medication / precautions?

    1
    II. Physical Examination
    Medical condition of:-
    Height 172 Weight 95 Kg Chest good
    Head good Nose good Lungs good
    Eyes good Pharynx good Heart good
    Ears good Neck good Reflexes good

    Remarks if any:-
    III. Medical Examination:- Routine Blood, (including Fasting & P.P), Urine Test and Chest
    X-Ray and any other test as deemed fit by the Medical Practitioner (to rule out any chronic
    disease).

    IV. Summary
    1. I believe this applicant IS / IS NOT physically able to carry on a full course of study, involving long
    hours of work, in a college or university in India.

    2. In my opinion the applicant’s health and physical condition in general are:

    Excellent

    Good

    Poor

    3. I certify that the applicant is up-to-date on routine vaccinations including, among others, MMR,
    DPT, Varicella, Hepatitis A & B etc.

    4. He / She has no physical condition / aliment which would hinder him from pursuing a full course of
    study in India.
    (yes )

    5. He / She present no evidence of any communicable disease or of any chronic fatigue.


    (yes)

    6. He / She does not have any chronic medical condition which requires regular and sustained
    medical treatment.
    (yes )

    NOTE: If answers to 4, 5 and 6 above are positive, please give details in Remarks column below.

    REMARKS
    Date Signature

    Address

    IMPORTANT:

    As a protective measure, those planning to study in India are strongly advised to get
    vaccinated against typhoid / cholera before coming to India.

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