SINGAPORE PRESS HOLDINGS LIMITED MEDICAL REPORT PATIENT'S NAME. SEX _NRIC/ PASSPORT NO. BIRTHOAYIMTHIYEAR Nanthakumar S/o Supramaniam F| |A40429195 31/01/1989 DEPARTMENT. ‘OCCUPATION [Tamil Murasu Limited [Sub-Editor No [Yes] 11 Yes, qve detais and date DISEASES OF NERVOUS SYSTEM? ‘severe headache, fainting attack, giddiness, loss of consciousness, paralysis, convulsions of any kind PSYCHIATRIC PROBLEMS Been seen treated by psychistist fy DISEASES OF EVES, EAR, NOSE AND THROAT ? impairment of vsion, hearing defect, sinus toublo hy DISEASES OF THE LUNGS ? asthma, chronic cough, blood - siting, TB [5 DISEASES OF HEART OF BLOOD VESSELS ? breathessness, palpation, murmu, high blood pressure, chest pain, heart attack DISEASES OF GASTRO - INTESTINAL SYSTEM? Lcer, abdominal pain, change in howel habit, bleeding, jaundine, galstone f7- DISEASES OF GENITAL - URINARY SYSTEM? suger, protein or blood in the urine, stone, infection, VO. DISEASES OF ENDOCRINE SYSTEM? thyroid disease, diabetes DISEASES OF BLOOD SYSTEM? anaemia, beeding, doting disorder [f0. DISEASES OF MUSCULO - SKELETAL SYSTEM? int pain, gout chronic backache, fracture [7 DISEASES OF SKIN? fr2. INFECTIOUS DISEASES? typhoic. cholera, malaria, hepatitis [i3._ GYNAECOLOGIC OR OBSTETRIC DISORDERS 7 menstrual regulary, breast lump ['4. SERIOUS INJURIES, MAJOR OPERATIONS AND HOSPITALISATIONS 7 [IS NATIONAL SERVICE ; Gompisted ? Deferred ? Exempted ? lig. ARE YOU A REGULAR BLOOD DONOR ? li7._ANY ILLNESS NOT MENTIONED ABOVE ? I FAMILY HISTORY [No_[Yes]ifVes, ve detals ‘SOCIAL HISTORY [No ]Yes]f Yes, gve detais FRyperension H Cigareiies Hear Disease: [2 Alcohot Isvoke [Diabetes IW DRUG HISTORY, uberculSTs H Drugs presently [Mental Disorder token ors [Alera hereby declare that | have not witheld any relevant information or made any misleading statement, and I give my consent to the 19 Medical Examiner to communicate with any physician who has attended to me. Signature ofwiness Name of Wines (Medieal Examiner) Toratweteamnes Dale|V. PHYSICAL EXAMINATION PRELIMINARIES MEASUREMENTS EVE TESTS [UNCORREGTED CORRECTED [PULSE RATE PERMIN Height) Vieua Acaty |_Right_6! @ ls.000 PRESSURE fein ck) Let_6! @ nm. 9.) Systoc Near Vison | Right N Diastoe left_N N Coteur vision | [—] Normal [] Abnormal [V. SYSTEMS REVIEW Normal [Abnormal Details h. Eyes, Ear, Nose & Trost fe. Hea & Neck a. roasts a. Respiratory System 5. Cardiovascular System &. Casto imestina! System 7. Ur - Genta System a. Muscle - Skeletal System a. Conta & Peripheral Nervous System Ho. skin [VI URINE: EXAMINATION lcnest x-ray [J Norma] Abnormal loners CONCLUSION & RECOMMENDATION cunie DoctorIPA-.S Pass G2297657M | 12 Jul 2017 MEDICAL FORM @ MANPOWER Medical Examination Form © This form isto be completed by a qualified doctor and retumed to the foreign employee. ‘* ‘The foreign employee must produce his/her passport and the In-Principle Approval letter from the Ministry of Manpower to the doctor. ‘© The foreign employee must submit this report to the Ministry of Manpower during card registration. A. Personal Particulars Name (as in te passpor): NANTHAKUMAR SUPRAMANIAM Sex: M Date of Birth: 31 JAN 1989 Medical: HIV Test and Chest X-Ray Test FIN: G3397657M Nationality: MALAYSIAN Passport No.: Ad0429195 B. Clinical Examination Remarks: 4. Cardiovascular System [ _|Normal Abnormal 2. Respiratory System Normal ‘Abnormal 3. Abdomen Normal Abnormal 4, Neurogical Normal Abnormal C. other Tests Chest Xray" Any evidence of acive TB detected?{ No [__]¥es [Dlexenione is pregnant ( Pregnrewemen re verse om Chest a) HIWAIDS): |__| Negative / Non-Reactive | Positive / Reactive Certification | cert that | have examined the above-named person and my findings are as above. |also ceriy thatheisheis [|e [Junit ———toremployment Name of Examining Doctor (n Hocker: Ginic's Stamp & Address: Signature of Examining Doctor: Telephone No, | Date | oun Ifthe examinee fails the medical examination, the In-Principle Approval will be deemed as withdrawn. If he/she is in Singapore, he/she must leave before the Short Term Visit Pass expires. iris of Manpower Work Pass Dsion wet hawamomgousy Canal shape gotepetat Page ottThis page has been intentionally left blank.