文档介绍：【附件】健康诊断书照片 Certificate of Health (Photo) 3㎝×4㎝姓名(Name) 性别(Sex) □ M( 男)□ F(女) ※钢印或骑缝章出生日期(Date of Birth) 电话号码(Phone Number) 护照号码(Passport Number) 地址(Address) 检查内容 Physical examination and Chest X- ray 身高(Height) 体重(Weight) 血压(Blood Pressure) cm Kg/ mmHg 检查日(Date of Chest) // X线检查□□□□ I. 结果(1) (Result): 非特异所見(Non - specific) □非活动性结核(Inactive TB) □活动性结核(Active TB) □→3- (Infective) □,非传染性(Non - infective) □→3- (Drug - sensitive TB) □,多剂耐性结核(MDR TB) II. 治疗结果(2) (Treatment es) - For person who has TB history 治疗中(Under treatment) □,完治(Cured) □完了(Completed Treatment) □治疗失败(Failed) □治疗漏落(Defaulted) □对上述项目进行了检查。 The examination was performed as above. 执照号码(License No.) :/ 医生姓名(Name of Physician): ( 签章) 检查结果(Summary of the examination) 对受检者停留的意见(Remarks about examinee ’s domestic stay) 仔细检查的必要性(Additional close examination) 以上是对受检者健康状态的结果与评估。 We hereby certify that the examinee's heath status is assessed as above. . ○○○○医院( 印章)