Print Certificate After 18 April 2022
id | Appointment # | Certificate # | AMS No | Surname | Fitst Name | ID Number | Date of Birth | Gender | Employer | Occupation | photo | Date | Time | Medical Type | Blood Glucose | Drug Test | X-Ray Results | Audiogram | PLH (% Loss of Hearing) | BP Systolic | BP Diastolic | BP Result | Rapid TB Test | Eye Test | Eye Test Equipment | Urinalysis | Lung Function Test | Working at Heights | Physical Examination | Annexure 3 Received | Signature | Practitioner Notes | Test Results | AMS Number | Certificate Expiry Date | height | weight | BMI | Pulse | Status | practitioner |
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id:
Appointment #:
Certificate #:
AMS No:
Surname:
Fitst Name:
ID Number:
Date of Birth:
Gender:
Employer:
Occupation:
photo:
Date:
Medical Type:
Blood Glucose:
Drug Test:
X-Ray Results:
Audiogram:
PLH (% Loss of Hearing):
BP Systolic:
BP Diastolic:
BP Result:
Rapid TB Test:
Eye Test:
Eye Test Equipment:
Urinalysis:
Lung Function Test:
Working at Heights:
Physical Examination:
Annexure 3 Received:
Signature:
Practitioner Notes:
Test Results:
AMS Number:
Certificate Expiry Date:
height:
weight:
BMI:
Pulse:
practitioner: