Employee Health Record Form

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Employee Health Record Form

Uploaded by

sagarsamal7289

We take content rights seriously. If you suspect this is your content, claim it here.

Available Formats

Download as PDF, TXT or read online on Scribd

D299 4882

Form No. 31-A

HEALTH RECORD
pre-employment/ Periodical)
Date: 22 ln La0as (Prescibed under Rula 62-J)

SI No: JJMS
Date of Birth :0+ |03lao04
PO No.(For contract employee):

:ADITYA ALUMINIUM, LAPANGA

1. Name of The Factory
2. Name of the Employee enojkanhe Sethi,
3. Name of the Agency
4. Employee Distinguishing Number
5. Age of the employee :a1 RS/ Ma le
Identification Mark

Nature of Job

6. Date of Employment
7. Length of Service in Years
8. General Survey :Good

Health : Good/ Fair TPoor

Height :16 Centimeter
Weight : G S Kilogram
9. Blood Group :'o'Positive / Negative
10. Eye Vision 6 16 Right., 6 Left.
Use Glass :Yes/ Nd
11. Clolour Vision :
Norena
12. Respiratory System & Chest Measurement
Inspiration :8 C.m
Expiration :34 C.m

Respiration rate/min : 18 / min

Remarks if any
13. Cardiovascular System
iPulse RatesA 31 :t0 breath/minutes
Blood
(steibO) Pressure
[Link] 1a41T mmHg
Heart Sound

Remarks if any
iSis2deide

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Employee Health Record Form

Uploaded by

Employee Health Record Form

Uploaded by

D299 4882

Form No. 31-A

:ADITYA ALUMINIUM, LAPANGA

Health : Good/ Fair TPoor

Respiration rate/min : 18 / min

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