英文体检报告模板.docx

英文体检报告模板

一、个人信息

PatientName:______________________

DateofBirth:______________________

Gender:____________________________

IDNumber:_________________________

二、体检日期

DateofExamination:__________________

三、体检项目及结果

1.GeneralPhysicalExamination（一般体检）

Height:______________________cm

Weight:______________________kg

BloodPressure:______________________mmHg

Pulse:______________________beats/min

2.EyeExamination（眼科检查）

Vision:LeftEye:______________________RightEye:______________________

ColorVision:Normal/Abnormal

3.Ear,NoseandThroatExamination（耳鼻喉科检查）

Hearing:Normal/Abnormal

Nose:Normal/Abnormal

Throat:Normal/Abnormal

4.DentalExamination（口腔检查）

ConditionofTeeth:______________________

GumCondition:______________________

5.InternalMedicineExamination（内科检查）

Heart:Normal/Abnormal

Lungs:Normal/Abnormal

Abdomen:Normal/Abnormal

6.LaboratoryTests（实验室检查）

BloodRoutine:______________________

Urinalysis:______________________

FecalOccultBloodTest:______________________

7.ImagingExamination（影像学检查）

ChestXray:______________________

Ultrasonography:______________________

四、体检结论

1.OverallHealthAssessment:______________________

五、医生签名

PhysiciansSignature:______________________

Date:______________________

四、专项检查

8.GynecologicalExamination（妇科检查）ForFemales

BreastExamination:Normal/Abnormal

PelvicExamination:Normal/Abnormal

PapSmear:______________________(resultstobeprovidedseparately)

9.ProstateExamination（前列腺检查）ForMales

DigitalRectalExamination:Normal/Abnormal

ProstateSpecificAntigen(PSA)Level:______________________ng/mL

10.CardiovascularExamination（心血管检查）

ECG(Electrocardiogram):______________________(interpretationtobeprovidedseparately)

CholesterolLevel:Total:______________________mg/dL,HDL:______________________mg/dL,LDL:______________________mg/dL