PDO Medical examinations specification SP1230

Petroleum Development Oman LLCRevision: 3.0Effective: 16 Apr 200723. Has he/she had regular dentalchecksNOYESIf yes, date last check NO YES24. Was the pregnancy with this child normal?25. Was the delivery normal?26. What was the birth weight? gms27. For children under 3 monthsIs breast/bottle feeding well stablished?If bottle fed, what Brand of milk is used?28. For children under 5 yearsHas there been any unusual delay (in reaching the usual milestones?) (e.g. sitting-up,crawling, walking, talking)29. Is the child on regular medication?30. For chlldren over 5 yearsIs he/she attending a normal school?Further details of any abnormal conditions noted above:(Please note the number of relevant question)EDUCATIONAL ASSESSMENT Please give details if you hav replied YES to any of thefollowing questions:31. Have there been any problems associated with the educational development of the child?Details:NOYES32. Has the child been referred to an educational psychologist?Details:33. Are there any medical or educational conditions of which a norrrial, school would need to beaware?Details:Please read the following statement and, if you agree, kindly sign it:I declare the above information to be true to the best of my knowledge and belief.Date: ................................................ Signature ofMotheror Fatheror GuardianFOR COMPLETION BY DOCTORFitWorldwideTemporarily unfit Signature (Doctor)Name (block capitals)Date:Page 83 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.