PDO Medical examinations specification SP1230

Petroleum Development Oman LLCRevision: 3.0Effective: 16 Apr 2007E1FOR COMPLETION BY EXAMINING DOCTOR OR SISTERFurther details of medical history and recreational activitiesN = NormalA = Abnormal (please describe)PHYSICAL EXAMINATIONNHEIGHTcmA1. Eyes & Pupils2. E.N.T.3. Teeth & Mouth4. Lungs & Chest5. Cardiovascular System6. Abdo. Viscera7. Hernial Orifices8. Anus & Rectum9. Genito-urinary10. Extremities11. Musculo-skeletal12. Skin & Varicose Vns.13. C.N.S.WEIGHTkgBMI B.P. PULSE HEARING VISION DISTANT NEAR ColourVisionBloodGroupLUncorrectedR L R LRCorrectedN A LABORATORY AND SPECIALINVESTIGATIONSNA1. Urinalysis 6. AudiogramAS INDICATED (2-11)7. Lung Function2. Hb Bloodcount ESR 8. Chest X-Ray3. Serum Profile 9. Drug Screen4. Stool 10. CR Screen =Country Request (e.g.H.I.V.)5. E.C.G. 11. OthersOTHER FINDINGSASSESSMENTFIT ALL AREAS FIT HOME SERVICE ONLY UNFIT/UNSUITABLE MAY BEREASSESSEDDate Signature Name (Block Capitals) Doctor/SisterPage 78 SP-1230 : Specification for Medical Examination, Treatment & Facilities Printed 25-Sep-08The controlled version of this CMF Document resides online in Livelink®. Printed copies are UNCONTROLLED.