文档介绍：外国人体格检查表FOREIGNERPHYSICALEXAMINATIONFORM姓名Name性别Sex□男Male□女Female出生日期BirthDay–Month-Year照片(加盖检查单位印章)Photo(stampedOfficialstamp)现在通信地址Presentmailingaddress血型Bloodtype国籍或地区Nationality(orArea)出生地址BirthPlace过去是否患有下列疾病:(每项后面请回答“否”或“是”)Haveyoueverhadanyofthefollowingdeseases?(Eachitemmustbeanswered“Yes”or“No”)斑疹伤寒Typhusfever□No□Yes菌痢Bacillarydysentery□No□Yes小儿麻痹症Poliomyelitis□No□Yes布氏杆菌病Brucellosis□No□Yes白喉Diphtheria□No□Yes病毒性肝炎Viralhepatitis□No□Yes猩红热Scarletfever□No□usinfection回归热Relapsingfever□No□Yes菌感染□No□Yes伤寒和付伤寒Typhoidandparatyphoidfever□No□erebrospinalmeningitis□No□Yes是否患有下列危机公共秩序和安全的病症:(每项后面请回答“否”或“是”)Doyouhaveanyofthefollowingdiseasesordisordersendangeringthepublicorderandsecurity?(Eachitemmustbeanswered“Yes”of“No”)ania………………………………………………………………………□No□Yes精神错乱Metalconfusion………………………………………………………………□No□Yes精神病Psychosis:躁狂型ManicPaychosis………………………………………□No□Yes妄想型Paranoidpsychosis………………………………………□No□Yes幻想型Hallucinatorypsychosis……………………………………□No□Yes身高厘米HeightCM体重公斤Weightkg血压毫米汞柱BloodpressuremmHg发育情况Development营养情况Nourishment颈部Neck视力左L________Vision右R矫正视力左L_______Correctedvision右R眼Eyes辨色力Coloursenses皮肤Skin淋巴结Lymphnodes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Nervoussystem其它所见Otherabnormalfindings胸部X线检查结果(附检查报告单)ChestX-rayExam(attachedchestX-rayreport)心电图ECG化验室检查(包括艾滋病、梅毒等血清学检查)Laboratoryexam(AttachedtestreportofAIDS,Syphilisetc)未发现患有下列检疫传染病和危害公共健康的疾病:Noneofthefol