General employment

♦ REPORT OF MEDICAL EXAMINATION ♦

DATE			NAME
COMPANY			Resident registration number
Department			TEL
Address
Contents
Height	㎝			Weight		㎏
Bust	㎝			Blood pressure
Hepatitis B				Blood Type (ABO/Rh)
Vision acuity (revision )	Left: ( )	Healing Level		Left :		Color Vision
	Right: ( )			Right :
Urinary disorders				Hemopoietic disease
Cardiovascular disease				Liver disease
Respiratory disease				ENT Disease
Mental-quality environment				Skin Diseases
Chest X-ray				L-S spine(Add)
Etc.
We hereby notice you of the result of your health examination. 201 . . . (sign)
Evaluation of fitness for work	□ Fit □ Unfit □ Decision pending			Reason for unfit
Reason for unfit& whether or not have precise test	＊If necessary,separate attached note.
Accordance with the provisions of [civil service recruitment medical examination] to prove that it has determined as above. Medical institute No.34100199 Dan-kook university Hospital (sign)
Valid : Awardone(1) year from