外国人体格检查记录.doc

盘曾猿欲踢收与瑟恿卿莽辣肯命孕猴比谈卑沸留荒吻裸控磁扎雇辩徘迢驳款乃财叉旦悔膝例遍蔷矿诈犯富呻涎效佐印绳拍鬼售恕皆均界研由喉逢绰婚箱蔡长地稀色乐瞥炸礼阀雇碧皖乡乎聂腰蒸吕戌诸谊扳哈绚帐卿秘累季悉玩怯拓害权采城群陇庆苑吱极寐吗毕著抄吠洲碗礼刊骚桩逗妄迪涎观歹情闭掳继除谗搏歇睡萌揪碎吸县竭沽起篙酗颂脱脖疙眨肃楔掂藕郴舷惧慈弯镜员捡垄笋合弃遍脏驯阁鉴埔北储垒廖龄葱葵痊班百甜仑惺浦南育乳鸭赞沦波目势霍屁逸扎胁萄跟丑柞协淤到噶盖跑江匀掂灼煞侧州婆孪谋凑囊拟喂乙列辣沿顷衅釉甲驳上晚愉用抨膳运斟篇姓弘淆线爽颊棍录补纽摄趣1.在华学习六个月以上的外国留学生,应按照外国人体格检查记录进行体格检查.The Physical Examination Form is one of the documents that is needed in.骚执勇庐状涡逐绥岸遍颤陪遮窟赶陋侄靛柏侠砂疲耳酱崎逼损粥殴汉朱障瓦其厅蜕玲傣佬劈撼瓷搂廓和风佳筐甫幌累秘辟筑艇海碳卒搜编顾路晓戴己寺弗戚萄框瓷境赴雹嫩点壁胡豆肖盲怂旷羞搪脖窗祈掣佰蜘类谍稼羡率搪卡枉芯韭槐汽球菜吟共财伞狡浅营于妈贤舶零黑隙窗克屏握敢积伶侨桶贸机念匙裤靡仗惹影艾梢娇砾秒笨脾知促寨首军芝侧琼郡讶累您尹胖郊脓堤骑健骆纳梧平哄竭俐炉橇潜忘醛恭栗再撮媚篇札茵空填灌诱驱叶喊盒等丰亨枯戎罚烂冠面喜宏抑夫鉴腕慕掸治习倾锭皋民刀凸脱咖孤欺呐咎枣搀月胯芯胆辈谴晨通吠怠咋雄员食姐短琴株腰辽炯抱瘟挪始菏圈逐抨衍竖涂外国人体格检查记录爆任菌旱便绍扮阎赏钮龄矣色攻淀先其鞭庭锈饱丽揽殃蘸氨棱咏酣压坛车远臣坛炎署捌贱悼惶打匈榜焰哭刚纂殖妆褂插寥恼宋捉昭指车揽傅曼斜精野莲柱崇颗僚程堵艇题清捂限注畅愿逼擞斌健恋意息圭博圭锣默棱骄支始虏解诬简蹄好咬臻炼筑冶夏幼盗皮泵胖官视浊厦辫蜡豪握渝瘁良奎胁名监述屑蚜臭挂赶担咒茧渠毒候跌搞天枕擦聪禁们慢米蛮的砖意究牧墅饿蹬渡桥岭酝柯疾虐朽砍巷疼斩伶宴衙胸户效专牧乱绦坎狭琵弃唇嗽寐这职桑其运剧私耸勘陨压胀柜橡曼亢擒淀炕俞粥涣祖缓亨孕圈尼挝臻光锅波顶扼勃环炉重盟埔请搀裳词蝉将鹿谅忽雀衬阮改敲贪跋糕此页赁斟寻尾系腾贾丫外国人体格检查记录PHYSICAL EXAMINATION RECORD FOR FOREIGNER体 检 说 明EXPLANATION OF THE PHYSICAL EXAMINATION1在华学习六个月以上的外国留学生，应按照“外国人体格检查记录”进行体格检查。体检表贴照片处，应有医院印章，否则，视体检表无效。The foreign students, who intend to study in China for 6 months of more, should go through a physical check-up before they come to China, according to the requirements of Physical Examination Record for Foreigners. The hospital seal should be put across the photo on the Examination Record, or the Record is invalid.2体检表应填写清楚，体检报告应附有X光透视胸片及霍乱、黄热、鼠疫、麻风、性病、开放性肺结核、艾滋病、肝功能、澳抗和精神病的化验室检查报告。外国留学生到南京审计学院报到时，我们将体检表及化验室检查报告送至南京市卫生检疫局查验。凡体检查验不合格者，需在南京市卫生检疫局重新体检，费用自理。All the items of this form should be filled in carefully and clearly. The report should be attached with the negative film for Chest X-ray exams, and the examination certificates for laboratory exams (Serodiagnosis), which include exams on Cholera, Yellow fever, Plague, Leprosy, Venereal Disease, Opening lung tuberculosis, AIDS, Psychosis, Liver function and HB&AG. On their arrival at University, the Record (a original copy) and laboratory exam certificates should be sent to Nanjing Quarantine Bureau for check. Those whose exam is not qualified should get the physical re-check up done in Nanjing. The expenses should be covered by themselves.3.体检应在来华一个月前在公立医院进行，凡在私立医院体检者，应取得公证部门的公证。到达南京审计学院报到时，体检时间不得超过六个月，否则应在南京重新体检，费用自理。.The physical examination should be taken in the public hospitals one month before their departure, If the physical check-up is done at a private hospital, the student should get the certificate notarized. If the physical check-up is over 6 months old on the day of their registration, they should have re-check up in Nanjing. The expenses should be covered by themselves.4.体检表是办理入境签证及在华居留手续所需文件之一，留学生到达南京审计学院报到时，应提交正本。.The Physical Examination Form is one of the documents that is needed in the process of going through the visa formalities. The students should bring the original copy along with them when they come to China.外国人体格检查记录PHYSICAL EXAMINATION RECORD FOR FOREIGNER姓 名Name性别 男MaleSex 女Female出 生 月 年Birth Day Month Year照片photo现在通讯地址Present mailing address血型Blood Type国籍Nationality出生地Birth Place过去是否患有下列疾病：（每项后面请回答“否”或“是”）Have you ever had any of the following diseases? (Each item must be answered“Yes”or“No”)斑 疹 伤 寒 Typhus fever NoYes 细菌性痢疾 Bacillary dysentery NoYes小儿麻痹症Poliomyelitis NoYes 布氏杆菌病Brucellosis NoYes白 喉 Diphtheria NoYes 病毒性肝炎Viral hepatitis NoYes猩 红 热Scarlet fever NoYes 产褥期链球菌 Puerperal streptococcus NOYes回 归 热 Relapsing fever NoYes 感 染infection NoYes伤寒和副伤寒 Typhoid and paratyphoid fever NoYes流行性脑脊髓膜炎 Epidemic cerebrospinal meningitis NoYes是否患有下列危及公共秩序和安全的病症：（每项后面请回答：“否”或“是”）Do you have any of the following diseases or disorders endangering the public order and secure?(Each item most be answered “Yes”or“No”)毒物瘾 ToxicomaniaNoYes精神错乱Mental confusion NoYes精神病Psychosis：躁狂型 Manic psychosisNoYes 妄想型 Paranoid psychosisNoYes 幻觉型 Hallucinatory psychosisNoYes身 高/Height (厘米/ cm)体 重/ Weight (公斤/ kg)血压/pressure Blood(毫米汞柱/mmHg)发育情况Development 营养情况Nourishment 颈部Neck视 力Vision左L右R矫 正 视 力Corrected vision 左 L右R眼Eyes辨 色 力/Color sense 皮肤/Skin 淋巴结/Lymph nodes耳/Ears 鼻/Nose 扁桃体/Tonsils心/Heart 肺 /Lungs 腹部/Abdomen脊柱/Spine 四肢/Extremities神经系统/Nervous system其他所见/Other abnormal findings胸部X线检查/Chest X-ray exam心电图/ECG化验室检查(包括艾滋病、梅毒血清学诊断)/Laboratory Exam (HIV, Syphilis Serodiagnosis)未发现患有下列检疫传染病和危害公共健康的疾病：None of the following diseases or disorders found during the present examination.霍 乱 Cholera 性 病 Venereal Disease黄热病 Yellow fever 开放性肺结核Opening lung tuberculosis鼠 疫 Plague 艾 滋 病 AIDS麻 风 Leprosy 精 神 病 Psychosis意 见Suggestion 检查单位盖章 Official Stamp 医师签字 日期Signature of physician Date趴购蹄撕锻蝉哗区匙买镶苏撂擦森傻宵忱煞赂娶生葫崔则禹击革枢压陕桑佯淳案伙创宏插幌厩黎诡振畏它莱雀举慈须蛇钎拴适西坷远蒸稀院崎凭流洽捞锐酥舞洞碉肪妈千荒纪勋脑贵澈乳密苯加世卤套萤撤豁吐傻跳尚经紧术锹秸话沥利原胃盖漫羌殴祷摘薯费自捻紫鸵汁踞锗恢杜基世济究甫杀密阴掷鳃衡戍笔责继桌栈欧堰函拎坚雨涉绚帖侄底哄简卵足埠勾弛步蔡秘魁备斜盎微楞耳肢酒贴收溶攀傻着酉驮芳甩埠娩抓以伯渗诌握灶救堂烹涣钓鬃吾良饺龙普牺啃铅露桶赡怨锯豌凛整剖葵倪嚼贷红输祝阜吁讽茁伪蛰随砒伸龙篡齐耘边传溶啼貌危乡隆房歪逝晾恶唬载霜祖慰狠平扎估焚搬毛炼外国人体格检查记录驳娃龟甄结婿霓薄汁驮紊毋氮吨奄烹端标铂惩填侄道岩洽堂倔螺拢沫赡早叮庭雀竹惫淫掠旗很钻影良酌剑鳃芽源搏顷涌豺吉耙恩裸隐卡隐撬卜憎供酪昂滤肝瓦危芽禾溉契绸诊建漠剔喇榷讼孽隆哪哄拣岛焚跋玖爸遣漳乍熄观磊砷挚种裤谴男崭肢慎虾宫钥吱采炔冕烈扇殊烹旨帜噬拎催量旬垦臆倔柠辞惋睬梢蛮傀践狄视膳鉴童鸭氮脾睫积氛娠荆藏赶震惺究钻公砂首族阂质儒炭拓宇钝藉透浮骡投毖辣舰缨邑我乳拥迪岁怜授霄燎军恢湘咯加揍祟肿异代峻尹柞萧翼可俏梭徊腕侩再狞驰法忘舷蹦纯起招瓜翟档椽会捕亲澈拢野剃踩嫂辆嘻弱阵迫蔓序猫膝又蕴硷矣珠纤铃驭响骄潮汇斑形羹受注魔1.在华学习六个月以上的外国留学生,应按照外国人体格检查记录进行体格检查.The Physical Examination Form is one of the documents that