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(handwriting) Negoi

Periodic Medical Examination


Date: 2010-02-09
Age: 7 years
Weight: 31 kg
Height: 134 cm
Interpretation: H II FM D+w
Skin and mucous membranes: normal
Limbs: normal
Vertebral Column: no anomalies
Posture: good
Visual acuity:...............
Auditory acuity: normal

Comprehensive health assessment:


Date: 2010-02-09
General condition: good
Osteoarticular system: normal
Subcutaneous tissue: well represented

Physical examination on organ systems


Respiratory system: ...................................
Cardiovascular system:..............................
clinically
Digestive system:........................................
normal
Genitourinary system: ................................

Psychomotor development:
.......................................................................................................
.......................................................................................................
Disharmonious physical development
Conclusion:....................................................................................
Clinically healthy
Recommendations:........................................................................

Dr. Drago Dragomir


(Doctor's seal and signature)

(Stamp) DOCTOR'S OFFICE


Elementary School No. 56

Periodic Medical Examination


Date:............................................................
Age:.............................................................
Weight:........................................................
Height:.........................................................
Interpretation:..............................................
Skin and mucous membranes: ..................
Limbs: ........................................................
Vertebral Column:.......................................
Posture:.......................................................
Visual acuity:...............................................
Auditory acuity:............................................

Comprehensive health assessment:


Date:...........................................................
General condition:.......................................
Osteoarticular system:................................
Subcutaneous tissue:..................................

Physical examination on organ systems


Respiratory system: ...................................
Cardiovascular system:..............................
Digestive system:........................................
Genitourinary system: ................................

Psychomotor development:
......................................................................
......................................................................
Conclusion:...................................................
Recommendations:......................................

IA CLASS

2010-05-13. Refuses Lunch


Dr. Drago Dragomir

2012-02-21
Refuses AP
(Stamp) GYMNASIUM NO. 56
SECTOR 2 BUCHAREST
DOCTOR'S OFFICE
SCHOOL DOCTOR'S OFFICE.................................................................................................

COMPREHENSIVE HEALTH ASSESSMENT

OF THE STUDENT Negoi Maria CLASS (YEAR) VIII A


Age (in years and months on the date of the examination) 14 Y

A. FAMILY FACTORS (collected from school teacher or form master)

-Family structure (both parents, maternal or paternal orphan, number of siblings)...................


-Living conditions (residence, family income)............................................................................
-Family atmosphere (alcoholism, violence etc. or normal)........................................................
-Student behavior within the family............................................................................................

B. PEDAGOGICAL FACTORS (collected from school teacher or form master)

-Studying efficiency (very good, good, average, very low - failed or flunked out of the
previous school year).................................................................................................................
-School inadaptation (school attendance and absences and specific events)......................

C. CONDITIONS AND SURGICAL PROCEDURES UNDERWENT SINCE THE PREVIOUS


COMPREHENSIVE MEDICAL EXAMINATION (collected from student, family, school
teacher or form master).............................................................................................................

D. CLINICAL EXAMINATION
- Vertebral Column.....................................................................................................................
-The rest of the locomotor system.............................................................................................
Within normal limits
-Heart.........................................................................................................................................
-Other apparatus and organ systems.........................................................................................

E. VISUAL ACUITY

VAOD (no correction).................................VAOS (no correction).............................................


VAOD (after correction)..............................VAOS (after correction)..........................................

Number and type of dioptres of the:


Right eye...............................................Left eye........................................................................
N
F. AUDITORY ACUITY: R.E. .........................................L.E. N
...................................................

G. SOMATOMETRIC MEASUREMENTS

-Date of measurements 2017-01 Age (on the date of measurements, in years and
months) 14,2
-Height (in cm) 165 Weight (in kg) 65
-Measurement interpretation (the height-weight index correlation) M2 FM D+

H. SEXUAL MATURITY

a) For boys - pubic hair (yes, no)................axillary hair (yes, no)...............facial hair (yes,
no)...............voice change (yes, no)...............
b) For girls - pubic hair (yes, no)................axillary hair (yes, no)................
- mammary gland (infantile, areola prominence or darkening, slightly grown breasts, medium
growth or visible)...............................
- menarche (absent, present and from what age in years and months)....................................
- menstrual problems (dysmenorrhea, irregular, heavy or light flow, hypermenorrhea with
specific number of days, missed periods)..................................
I. PHYSICAL EFFORT CAPACITY IN PHYSICAL EDUCATION CLASSES ( athlete, very
good, satisfactory, limited, medical exemption, partial or complete)..........................................
CONCLUSIONS:

Physical development ( normal, short, tall stature, harmonic or disharmonic by


excess or low weight) Disharmonic + weight
Visual acuity after correction (normal or low and in what eye).....................................
Physical examination (healthy or with chronic conditions or that can become chronic,
infirmities and what are they, clinical severity - mild, moderate, severe clinically
healthy upon examination

School - professional orientation (for 8th and 12th grade)


No medical restrictions (yes, no)......................................
Medical restrictions............................................................
Name of doctor (who did the examination) Dr. Liana Man
DR. LIANA MAN
GENERAL MEDICINE
CODE
Doctor's seal and signature............................................

Date of the comprehensive health assessment 2017-04


NAME OF THE SCHOOL'S MEDICAL NURSE Radu Mihaela
(Signature)

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