PDO Medical examinations specification SP1230

More documents

Recommendations

Info

Petroleum Development Oman LLCRevision: 3.0Effective: 16 Apr 2007Are you a RegisteredDisabled Person?Yes No Do you belong to anyMedical Insurance Scheme?BUPA / PPP / AMA/ OtherYesNoPlease answer the following questions and tick „N‟ („no‟) or „Y‟ (yes) column. If „Y‟ please describeN Y DescriptionHave you, since your last medical been treated by your familydoctor or specialist for other than minor ailments?Do you take any medicines regularly, or have you done so in therecent past?Do you smoke? If yes, what and how much each day?Do you drink alcohol? If yes, what is your average weekly intake?Are you doing regular sports or physical activities?Have you, since your last medical, had any of the following (minorailments need not be mentioned):N Y Description1. Ear, nose and throat problems2. Eye problems3. Chest problems like asthma, bronchitis4. Heart abnormality, chest pains5. Abdominal pains, abnormal bowel motions6. Urogenital problems (kidney disease, menstrual disorder) forwomen only: last menstrual period (LMP):7. Musculoskeletal diseases8. Skin trouble or allergies9. Epileptic fits, dizzy spells or migraine10. Diabetes, anemia, blood disorders11. Any other health problem, accident of fracturesSTATEMENT: I have read the above questions.The answers are correct and no information concerning my present or past state of health has been withheld.Signed: ......................................................................... Date: ..........................................Page 80 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.
Petroleum Development Oman LLCRevision: 3.0Effective: 16 Apr 2007EX2FOR COMPLETION BY EXAMINING DOCTORFurther details of medical history since last examination(N = Normal, A = 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.14.15.WEIGHTkgB.P. PULSE HEARING VISION DISTANT NEAR Colour VisionBlood GroupLRUncorrectedCorrectedN A LABORATORY AND SPECIALINVESTIGATIONS1. Urinalysis 6. Audiogram2. Hb BloodcountESRNA7. Lung Function3. Serum Profile 8. Chest X-Ray4. Stool 9. Drug Screen5. E.C.G. 10. CR Screen = CountryRequest (e.g. H.I.V.)ASSESSMENT AND RECOMMENDATIONSFit Worldwide FIT Restricted Service Temporarily Unfit (See correspondence)Signature ........................................................................................ Doctor/SisterC.M.O.‟s Initials ............................................................................... Date ............................................................Name (Block Capitals) ...........................................................................................................................................Page 81 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.
Page 1 and 2:
RESTRICTEDApr 2009Document ID: SP-1
Page 3 and 4:
Petroleum Development Oman LLCRevis
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30: Petroleum Development Oman LLCRevis
Page 51 and 52: QuestionnaireExaminationBMIVisionCo
Page 53 and 54: AircraftrefuellingUse ofBreathingeq
Page 79: Petroleum Development Oman LLCRevis
Page 87: Petroleum Development Oman LLCRevis
show all

PDO Medical examinations specification SP1230

Create successful ePaper yourself

Delete template?

Save as template?