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    004 - Pre_employment_test

    Uploaded by

    Manoj luhach

    Copyright:

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

    004 - Pre_employment_test

    Uploaded by

    Manoj luhach
    4 views5 pages

    Copyright

    © © All Rights Reserved

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    DOC, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    4 views5 pages

    004 - Pre_employment_test

    Uploaded by

    Manoj luhach

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 5

    Dear Manoj,

    You are supposed to complete the following test in your Pre-employment from any reputed
    hospital. The same expenses will be reimbursing at time of your join.

    Pre-Employment
    1) History Full Medical History & Immunization History
    Full physical examination including Height, Weight, Blood Pressure, Vision
    2) Physical Examination
    Test & Color Vision
    a) FBS
    b) PP2BS
    c) Complete Hemogram with ESR
    d) SGPT
    e) SGOT
    f) Lipid Profile
    3) Blood Examination g) S. Creatinine
    h) S. Urea
    i) S. Uric Acid
    j) Gamma GT
    k) S. Bilirubin
    l) Hbs-Ag & Anti Hbs-Ab
    m) Blood Group
    4) Urine Examination Routine & Microscopic
    5) ECG
    6) X-Ray - Chest PA View
    7) Audiometry
    8) Spirometry

    Regards,

    Dhananjay Salvi
    Sr. HR Business Partner & Talent Acquisition Lead

    Sensitivity: Business Internal


    QUESTIONNAIRE FOR HEALTH CHECK – UP

    CANDIDATE NAME:

    QUALIFICATION

    OCCUPATION:

    RELIGIO
    BLOOD GROUP SEX DATE OF BIRTH
    N
    MARITAL STATUS: Single / Married / Widower

    NAME OF FATHER NAME OF MOTHER

    DOB FATHER DOB MOTHER

    NAMES OF YOUR CHILDREN SEX DATE OF BIRTH BLOOD GROUP (If you know)

    NAMES OF YOUR BROTHER / SISTERS SEX DATE OF BIRTH BLOOD GROUP (If you know)

    NAME OF YOUR SPOUSE SEX DATE OF BIRTH BLOOD GROUP (If you know)

    Sensitivity: Business Internal


    Have a Family history of If yes, who suffered? and at what age?

    Diabetes / Mellitus Yes / No


    High Blood Pressure Yes / No
    Heart Disease Yes / No
    Asthma Yes / No
    Tuberculosis Yes / No
    Cancer Yes / No
    Kidney Trouble Yes / No
    Others Yes / No
    Past Personal Medical History If Yes, please provide details

    Any Accident in the past Yes / No


    Have you been admitted to any hospital in the past? Yes / No
    Any investigations in the past Yes / No
    Any history of allergy? Yes / No
    Any Major illness in past Yes / No
    Any surgical operation in the past? Yes / No
    Have you taken any Drugs in the past? Yes / No
    Have you ever been denied life Insurance? Yes / No
    Have you been advised to have further investigations /
    Yes / No
    operations?
    Do you have any difficulty with hearing? Yes / No
    Have you had any problem with your eyes or vision? Yes / No
    Do you wear Specials / Contact Lenses? Yes / No
    Have you any difficulty with speech? Yes / No
    Do you have any Urinary Symptoms? Yes / No
    Have you any difficulty in swallowing? Yes / No
    Do you have any breathing difficulty? Yes / No
    Do you have any chest pain? Yes / No
    Do you sleep well? Yes / No
    Have you ever suffered from Fits / Convulsions? Yes / No
    Have you ever suffered with any Skin problems? Yes / No

    Sensitivity: Business Internal


    Do you Smoke? Yes / No Since when?
    How much?
    Do you consume Alcohol? Yes / No Quantity Pegs
    Per Day / week / Months

    Which physical activity you do?

    Walking: Exercise: Sports:


    Yoga: Others:

    Present Medical Complaints and their duration along with list of Medicines / Drugs you are taking now:

    Sign & Seal of Doctor

    Sensitivity: Business Internal


    HEALTH CHECK – UP EXAMINATION

    NAME: SEX: AGE:

    PAST MEDICAL HISTORY:

    PRESENT COMPLAINTS & MEDICATION:

    PHYSICAL EXAMINATION
    HIGHT: TEMP.: PULSE:
    WEIGHT: SKIN: BLOOD PRESSURE:
    OEDEMA: LYMPHADENOPATHY: PERIPHERAL VESSELS:
    GENERAL EXAMINATION:

    SYSTEMIC EXAMINATION:
    C.N.S R.S.
    C.V.S ABDOMEN
    INVESTIGATIONS:

    TREATMENT / RECOMMENDATIONS:

    Sign & Seal of Doctor

    Sensitivity: Business Internal

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