国际旅游健康证明书英文部分.docVIP

NOTES This certificate is valid only if completed with the date of issue, signature of physician and the official stamp of the Entry-Exit Inspection and Quarantin authorities of the People’s Republic of China. The validity of this certificate shall extend for a period of one year starting date of issue. The owner must always keep this certificate with himself against inspection on departing from or arriving in a country or at his place residing. The “Normal” status in the certificate is valid only as of when the examinee took the exams. The certificate shows the examinee has had the medical exams, and it records the medical results accurately, which only indicates the health condition of the examinee when the exams were taken. Any amendment of this certificate, or erasure, or misuse by other person, may render it invalid. No. Surname: Given Names: Sex: Date of Birth: Nationality: CHINESE Blood Type: Address of lssue: General check Height: cm Weight : kg Pulse rate: times/min BP: mmHg Temperature: ℃ Medicine Surgery Skin, Sclera, Lymph Nodes: Normal Head Neck: Normal Chest Lungs: Normal Heart: Auscultation heart : Normal Abdomen: Normal Spine Extremities: Normal Neuropsychiatric System: Normal Genitourinary System: N E.E.N.T. Innc.Vision: Left Right Corr. Vision: Left Right Color Sense: Hearing: Left Normal Right Normal Eyes, Ears, Nose, Throat: Normal ECG Abdomen Ultrasound (Liver, Gallbladder, Spleen, Kidney) Liver, gallbladder, spleen, double kidney , echo camer no abnormal findings. Chest X-ray No abnormal findings of heart lungs and diaphragm. Laboratory Tests Anti-HIV: Negative Syphilis Serology: Negative HBsAg: Negative Anti-HCV: Negative ALT(GPT): (Normal: 5-40) Blood Routine WBC: RBC: PLT: HGB: NEUT%: LYM%: Laboratory Tests Urine Routine GLU: PRO: ERY: LEU: Others: ******** General Comments None of diseases or disorders found endangering the public order and security. Name of doctor in charge: Sign