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<DIV id="page_1">
<P class="p0 ft0">Reg no...........................</P>
<P class="p1 ft1">REPORT OF MEDICAL EXAMINATION OF SEAFARER BY ANAPPROVED MEDICAL EXAMINER.</P>
<P class="p2 ft2">As per Merchant Shipping (Medical Examination) Rules 2000 and ISM / STCW code 1/9 and ILO covention 147</P>
<P class="p3 ft3"><NOBR>HI-CARE</NOBR> <NOBR>MEDI-CENTRE</NOBR></P>
<P class="p4 ft0 ">Door No. 39/1492,1<SPAN class="ft4">st </SPAN>Floor, Kalathiparampil Cross Road, Ernakulam South, Cochin - 682016.</P>
<p class="p5 ft0">Phone : <NOBR>0484-2375557,</NOBR> 9895209326</P>
<TABLE cellpadding=0 cellspacing=0 class="t0">
<TR>
<TD colspan=13 rowspan=2 class="tr0 td0"><P class="p6 ft5">Name: <?=$customer['customer_name']?></P></TD>
<TD class="tr1 td1"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td3"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td5"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td7"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td8"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td9"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td4"><P class="p7 ft6"> </P></TD>
<TD colspan=4 rowspan=2 class="tr0 td11"><P class="p8 ft5">Sex</P></TD>
<TD colspan=3 rowspan=2 class="tr0 td12"><P class="p9 ft5"><?=$customer['gender']?></P></TD>
<TD colspan=5 rowspan=2 class="tr0 td13"><P class="p10 ft5">Serial No:</P></TD>
<TD class="tr1 td14"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr1 td15"><P class="p11 ft7"><?=$customer['lead_id']?></P></TD>
<TD class="tr1 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr1 td18"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD class="tr2 td1"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td2"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td3"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td5"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td6"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td7"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td8"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td9"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td10"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td14"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td19"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td10"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td2"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td14"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td20"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td17"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td18"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD class="tr3 td21"><P class="p7 ft9"> </P></TD>
<TD class="tr4 td22"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td23"><P class="p7 ft10"> </P></TD>
<TD colspan=3 class="tr4 td24"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td25"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td26"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td27"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td26"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td28"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td29"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td30"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td31"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td32"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td33"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td25"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td34"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td24"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td22"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td35"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td23"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td25"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td36"><P class="p7 ft10"> </P></TD>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td37"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td38"><P class="p7 ft9"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr3 td40"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td37"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td41"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td6"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td18"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr4 td42"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td44"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td46"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td48"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td50"><P class="p7 ft10"> </P></TD>
</TR>
<TR>
<TD colspan=9 class="tr5 td51"><P class="p12 ft5">Date of Birth: <NOBR><?=$customer['dob']?></NOBR></P></TD>
<TD class="tr5 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td52"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td12"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td1"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td3"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td4"><P class="p7 ft6"> </P></TD>
<TD colspan=6 class="tr5 td53"><P class="p13 ft5">PP/CDC: <?=$customer['passport_no']?></P></TD>
<TD class="tr5 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td54"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td37"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td38"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td37"><P class="p7 ft6"> </P></TD>
<TD colspan=4 class="tr5 td55"><P class="p14 ft5">Rank:<?=$customer['rank']?></P></TD>
<TD class="tr0 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td44"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td48"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr0 td50"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td56"><P class="p15 ft5">Vessel:<?=$customer['vessel']?></P></TD>
<TD class="tr6 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td25"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td57"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td25"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td26"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td27"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td26"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td28"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td29"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td30"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td31"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td3"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr6 td58"><P class="p7 ft5">Type:<?=$customer['type']?></P></TD>
<TD class="tr6 td7"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td22"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td35"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td23"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td25"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td36"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td59"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td60"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td61"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td26"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td62"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td37"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr6 td13"><P class="p14 ft5">Route:</P></TD>
<TD class="tr6 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td19"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td18"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=2 class="tr8 td63"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td10"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr8 td64"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td65"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td66"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td67"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td66"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td68"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td69"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td70"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr8 td71"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr8 td72"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td5"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr8 td73"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td74"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td75"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr8 td74"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr8 td76"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td77"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td78"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td79"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td80"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td37"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td18"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td81"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td19"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr8 td18"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=31 rowspan=2 class="tr1 td82"><P class="p15 ft0"><SPAN class="ft5">Home Address</SPAN>: <?=$customer['address']?></P></TD>
<TD class="tr4 td41"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td6"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td18"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td42"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td46"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td48"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td50"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD class="tr6 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td18"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td81"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td19"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td18"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=2 class="tr6 td63"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td10"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr6 td73"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td83"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td84"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td83"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td85"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td86"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td87"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td88"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td89"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td90"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td91"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td92"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td87"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td93"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td94"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td95"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td96"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td91"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td97"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td98"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td99"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td100"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td83"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td101"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td99"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td102"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td87"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td103"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td91"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td104"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td105"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td106"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td96"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td89"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td105"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td98"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td83"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td107"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td91"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td103"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=9 class="tr10 td51"><P class="p6 ft5">Company Name :</P></TD>
<TD class="tr10 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td52"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td12"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td1"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td3"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td5"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td7"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td8"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td9"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td54"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td37"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td38"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td37"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td18"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td81"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td19"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td18"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=2 class="tr4 td108"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD colspan=3 class="tr4 td109"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td46"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td110"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td111"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td112"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td113"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td114"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td46"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td115"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td116"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td109"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td117"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td118"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td117"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td119"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td120"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td121"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD colspan=2 class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td122"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td113"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td50"><P class="p7 ft10"> </P></TD>
<TD colspan=3 class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td44"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td46"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td48"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td50"><P class="p7 ft10"> </P></TD>
</TR>
<TR>
<TD colspan=9 class="tr10 td123"><P class="p16 ft11">Medical History</P></TD>
<TD class="tr10 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td111"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td112"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td114"><P class="p7 ft6"> </P></TD>
<TD colspan=28 class="tr10 td124"><P class="p17 ft12">Please answer the following to the best of your knowledge</P></TD>
<TD class="tr10 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td48"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td50"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=12 rowspan=2 class="tr1 td125"><P class="p18 ft13">Is there any past / present history of any</P></TD>
<TD class="tr11 td6"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td1"><P class="p7 ft14"> </P></TD>
<TD colspan=2 class="tr11 td126"><P class="p19 ft15">Candidate</P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD colspan=3 class="tr11 td127"><P class="p20 ft2">Examiner</P></TD>
<TD class="tr11 td8"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td9"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td10"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td54"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td37"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td38"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td16"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td40"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td37"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td41"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td6"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td18"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td81"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td128"><P class="p7 ft14"> </P></TD>
<TD colspan=4 class="tr11 td129"><P class="p16 ft2">Candidate</P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD colspan=4 class="tr11 td130"><P class="p7 ft2">Examiner</P></TD>
</TR>
<TR>
<TD class="tr12 td6"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td1"><P class="p7 ft16"> </P></TD>
<TD colspan=2 rowspan=2 class="tr13 td126"><P class="p7 ft15">Decleration</P></TD>
<TD class="tr12 td4"><P class="p7 ft16"> </P></TD>
<TD colspan=3 rowspan=2 class="tr13 td127"><P class="p12 ft17">Record</P></TD>
<TD class="tr12 td8"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td9"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td10"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td4"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td54"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td20"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td37"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td38"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td16"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td40"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td37"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td41"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td6"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td18"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td4"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td81"><P class="p7 ft16"> </P></TD>
<TD class="tr12 td128"><P class="p7 ft16"> </P></TD>
<TD colspan=4 rowspan=2 class="tr13 td129"><P class="p13 ft17">Decleration</P></TD>
<TD class="tr12 td20"><P class="p7 ft16"> </P></TD>
<TD colspan=4 rowspan=2 class="tr13 td130"><P class="p21 ft17">Record</P></TD>
</TR>
<TR>
<TD colspan=5 rowspan=3 class="tr6 td131"><P class="p18 ft13">of the following</P></TD>
<TD class="tr2 td132"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td133"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td52"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td134"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td6"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td1"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td8"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td9"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td10"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td54"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td20"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td37"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td38"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td40"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td37"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td41"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td6"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td18"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td81"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td128"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td20"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD class="tr2 td132"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td133"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td52"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td134"><P class="p7 ft8"> </P></TD>
<TD class="tr14 td113"><P class="p7 ft18"> </P></TD>
<TD colspan=2 class="tr14 td135"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td136"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td49"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td137"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td113"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td138"><P class="p7 ft18"> </P></TD>
<TD class="tr2 td8"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td9"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td10"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td54"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td20"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td37"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td38"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td16"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td40"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td37"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td41"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td6"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td18"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td81"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td128"><P class="p7 ft8"> </P></TD>
<TD class="tr14 td44"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td45"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td46"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td139"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td47"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td39"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td48"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td49"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td50"><P class="p7 ft18"> </P></TD>
</TR>
<TR>
<TD class="tr15 td140"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td110"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td142"><P class="p19 ft20">Yes</P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p22 ft20">Yes</P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD class="tr15 td117"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td118"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td45"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td121"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td145"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td141"><P class="p16 ft21">Yes</P></TD>
<TD colspan=2 class="tr15 td146"><P class="p23 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td144"><P class="p24 ft20">Yes</P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p25 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=12 class="tr15 td148"><P class="p18 ft22">Severe <NOBR>one-sided</NOBR> headaches (Miqraine)</P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD colspan=13 class="tr15 td150"><P class="p6 ft22">Hernia / Hydrocoele / Appendicitis</P></TD>
<TD class="tr15 td50"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p25 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=12 class="tr15 td148"><P class="p18 ft22">Head Injury / Concussion / Loss of Memory</P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD colspan=16 class="tr15 td152"><P class="p6 ft22">High / Low blood pressure / Heart disease</P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p25 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=12 class="tr15 td148"><P class="p18 ft22">Ffits / Epilepsy / Dizziness / Fainting</P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD class="tr15 td117"><P class="p7 ft19"> </P></TD>
<TD colspan=12 class="tr15 td153"><P class="p7 ft22">Asthama / Bronchitis / Tuberculosis</P></TD>
<TD class="tr15 td50"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p25 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=12 class="tr15 td148"><P class="p18 ft22">Eye / Vision Problems (Glasses, etc)</P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD class="tr15 td117"><P class="p7 ft19"> </P></TD>
<TD colspan=7 class="tr15 td154"><P class="p7 ft22">Allerqy / Skin disease</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td145"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p27 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr15 td123"><P class="p18 ft22">Hearing Impairment</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD class="tr15 td117"><P class="p7 ft19"> </P></TD>
<TD colspan=10 class="tr15 td156"><P class="p7 ft22">Infection / Contaqious disease</P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p27 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr13 td123"><P class="p18 ft23">Ear / Nose / Throat Problems</P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td141"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td149"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p16 ft25">No</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td143"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft25">No</P></TD>
<TD colspan=13 class="tr13 td150"><P class="p6 ft23">Addiction to alchohol / Druqs / Tobacco</P></TD>
<TD class="tr13 td50"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td42"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td139"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td44"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td151"><P class="p7 ft24"> </P></TD>
<TD colspan=2 class="tr13 td146"><P class="p26 ft25">No</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td48"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td147"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td155"><P class="p27 ft25">No</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr15 td123"><P class="p28 ft22">Stomach / Bowel Disorders</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD colspan=16 class="tr15 td152"><P class="p6 ft22">Fracture / Dislocation / Injury / Amputation</P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p27 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr13 td123"><P class="p18 ft23">Gall Stones / Kidney Disorders</P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td141"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td149"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p16 ft25">No</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td143"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft25">No</P></TD>
<TD colspan=8 class="tr13 td157"><P class="p6 ft23">Major / Minor Operation</P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td145"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td50"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td42"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td139"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td44"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td151"><P class="p7 ft24"> </P></TD>
<TD colspan=2 class="tr13 td146"><P class="p26 ft25">No</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td48"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td147"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td155"><P class="p27 ft25">No</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr15 td123"><P class="p18 ft22">Jaundice / Liver Disease</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD colspan=3 class="tr15 td158"><P class="p6 ft22">Diabetes</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td121"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td145"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td50"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p27 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr15 td123"><P class="p18 ft22">Piles / Varicise Veins</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p16 ft21">No</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td143"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft21">No</P></TD>
<TD colspan=16 class="tr15 td152"><P class="p6 ft22">Nervous / Mental Disease / Sleep disorder</P></TD>
<TD class="tr15 td139"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td44"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td151"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td146"><P class="p26 ft21">No</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p27 ft21">No</P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td159"><P class="p18 ft23">Blood Disorder</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td140"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td110"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td141"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td149"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p16 ft25">No</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td143"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft25">No</P></TD>
<TD colspan=11 class="tr13 td160"><P class="p6 ft23">Mallignant disease ( Cancer )</P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td50"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td42"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td139"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td44"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td151"><P class="p7 ft24"> </P></TD>
<TD colspan=2 class="tr13 td146"><P class="p26 ft25">No</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td48"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td147"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td155"><P class="p27 ft25">No</P></TD>
</TR>
<TR>
<TD colspan=5 class="tr16 td131"><P class="p18 ft26">Femaie Disorder</P></TD>
<TD class="tr16 td140"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td49"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td39"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td110"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td39"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td111"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td141"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td113"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td114"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td149"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td136"><P class="p16 ft28">No</P></TD>
<TD class="tr16 td49"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td143"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td113"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td138"><P class="p7 ft28">No</P></TD>
<TD colspan=16 class="tr16 td152"><P class="p6 ft26">Signed off on medical qrounds / Declared Unfit</P></TD>
<TD class="tr16 td139"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td44"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td151"><P class="p7 ft27"> </P></TD>
<TD colspan=2 class="tr16 td146"><P class="p26 ft28">No</P></TD>
<TD class="tr16 td47"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td39"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td48"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td147"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td155"><P class="p27 ft28">No</P></TD>
</TR>
<TR>
<TD colspan=3 class="tr11 td159"><P class="p18 ft29">notes</P></TD>
<TD class="tr11 td47"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td140"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td39"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td110"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td39"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td111"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td112"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td113"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td114"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td46"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td136"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td116"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td113"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td161"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td117"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td118"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td45"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td144"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td47"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td120"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td121"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td39"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td145"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td120"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td122"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td113"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td50"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td42"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td43"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td44"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td45"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td46"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td43"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td47"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td39"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td48"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td155"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=9 class="tr7 td123"><P class="p22 ft30">Medical Examination</P></TD>
<TD class="tr7 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td111"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td112"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td114"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td136"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td116"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td161"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td117"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td118"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td144"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td121"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td145"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td122"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td50"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td44"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td48"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td155"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr11 td162"><P class="p29 ft29">Height CM</P></TD>
<TD class="tr11 td47"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD colspan=4 class="tr11 td163"><P class="p30 ft29">Weight in Kgs</P></TD>
<TD colspan=3 class="tr11 td164"><P class="p26 ft31">Chest <NOBR>Insd-Exp</NOBR></P></TD>
<TD colspan=9 class="tr11 td165"><P class="p30 ft31">Blood Pressure in mm of Hg</P></TD>
<TD colspan=5 class="tr11 td166"><P class="p19 ft29"><NOBR>Pulse-Beats /</NOBR> min</P></TD>
<TD class="tr11 td120"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td121"><P class="p7 ft14"> </P></TD>
<TD colspan=8 class="tr11 td167"><P class="p31 ft29">Resp.Rate / min</P></TD>
<TD class="tr11 td139"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td44"><P class="p7 ft14"> </P></TD>
<TD colspan=8 class="tr11 td168"><P class="p21 ft29">General Condition</P></TD>
</TR>
<TR>
<TD class="tr9 td169"><P class="p32 ft32"><?=$customer['height']?></P></TD>
<TD class="tr9 td117"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td151"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr9 td116"><P class="p33 ft33"><?=$customer['weight']?></P></TD>
<TD class="tr9 td170"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr9 td164"><P class="p34 ft34"><NOBR><?=$customer['chest']?></NOBR></P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr9 td159"><P class="p35 ft33"><?=$customer['bp']?></P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td161"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td171"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr9 td172"><P class="p36 ft33"><?=$customer['pulse']?></P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td144"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td173"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td121"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td145"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td122"><P class="p37 ft33"><?=$customer['rr']?></P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td50"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td139"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td44"><P class="p7 ft6"> </P></TD>
<TD colspan=6 class="tr9 td158"><P class="p13 ft35">HEALTHY</P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td155"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr16 td162"><P class="p18 ft36">Distant Vision</P></TD>
<TD class="tr16 td47"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td49"><P class="p7 ft27"> </P></TD>
<TD colspan=4 class="tr16 td163"><P class="p7 ft26">Uncorrected</P></TD>
<TD class="tr16 td39"><P class="p7 ft27"> </P></TD>
<TD colspan=2 class="tr16 td174"><P class="p38 ft37">Corrected</P></TD>
<TD class="tr16 td113"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td114"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td46"><P class="p7 ft27"> </P></TD>
<TD colspan=4 class="tr16 td175"><P class="p7 ft26">Field of Vision</P></TD>
<TD class="tr16 td161"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td171"><P class="p7 ft27"> </P></TD>
<TD colspan=2 class="tr16 td172"><P class="p30 ft38">Audiometry</P></TD>
<TD class="tr16 td147"><P class="p7 ft27"> </P></TD>
<TD colspan=2 class="tr16 td176"><P class="p39 ft26">Hz</P></TD>
<TD colspan=2 class="tr16 td146"><P class="p21 ft26">500</P></TD>
<TD colspan=3 class="tr16 td141"><P class="p33 ft26">1000</P></TD>
<TD class="tr16 td177"><P class="p13 ft26">2000</P></TD>
<TD class="tr16 td113"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td155"><P class="p40 ft38">3000</P></TD>
<TD class="tr16 td49"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td42"><P class="p7 ft27"> </P></TD>
<TD colspan=2 class="tr16 td178"><P class="p32 ft38">4000</P></TD>
<TD colspan=2 class="tr16 td176"><P class="p13 ft26">5000</P></TD>
<TD colspan=3 class="tr16 td179"><P class="p32 ft26">6000</P></TD>
<TD class="tr16 td48"><P class="p7 ft27"> </P></TD>
<TD colspan=2 class="tr16 td141"><P class="p27 ft26">8000</P></TD>
</TR>
<TR>
<TD colspan=3 class="tr11 td162"><P class="p41 ft29">Right Eye</P></TD>
<TD class="tr11 td47"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD colspan=3 class="tr11 td116"><P class="p33 ft32"><?=$customer['dreuc']?></P></TD>
<TD class="tr11 td170"><P class="p7 ft14"> </P></TD>
<TD colspan=2 class="tr11 td180"><P class="p42 ft39"><?=$customer['drec']?></P></TD>
<TD class="tr11 td141"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td113"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td114"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td46"><P class="p7 ft14"> </P></TD>
<TD colspan=4 class="tr11 td175"><P class="p30 ft29">Normal</P></TD>
<TD class="tr11 td161"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td171"><P class="p7 ft14"> </P></TD>
<TD colspan=2 class="tr11 td172"><P class="p30 ft29">Right Ear</P></TD>
<TD class="tr11 td147"><P class="p7 ft14"> </P></TD>
<TD colspan=2 class="tr11 td176"><P class="p43 ft29">dB</P></TD>
<TD class="tr11 td120"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td181"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td39"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td145"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td182"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td177"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td113"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td155"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td42"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td43"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td183"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td45"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td149"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td43"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td47"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td184"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td48"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td49"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td155"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr15 td162"><P class="p44 ft22">Left Eye</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td116"><P class="p33 ft40"><?=$customer['dleuc']?></P></TD>
<TD class="tr15 td170"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td180"><P class="p42 ft39"><?=$customer['dlec']?></P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td46"><P class="p7 ft19"> </P></TD>
<TD colspan=4 class="tr15 td175"><P class="p30 ft22">Abnormal</P></TD>
<TD class="tr15 td161"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td171"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td172"><P class="p19 ft22">Left Ear</P></TD>
<TD class="tr15 td147"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td176"><P class="p43 ft22">dB</P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td181"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td145"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td182"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td177"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td42"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td43"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td183"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td45"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td149"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td43"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td184"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td48"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td155"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD colspan=2 rowspan=2 class="tr17 td185"><P class="p28 ft41">Color Vision</P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD colspan=5 class="tr15 td186"><P class="p45 ft22">Ishihara</P></TD>
<TD class="tr15 td187"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td52"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td188"><P class="p24 ft42"></P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD colspan=5 class="tr15 td189"><P class="p18 ft22">Abnormal</P></TD>
<TD class="tr15 td190"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td191"><P class="p23 ft22">Hearing</P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD colspan=7 class="tr15 td192"><P class="p7 ft22">Normal Voice</P></TD>
<TD class="tr15 td18"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td81"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD colspan=7 class="tr15 td193"><P class="p46 ft43">Whispered Voice</P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td132"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td195"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td187"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td196"><P class="p16 ft23">Normal</P></TD>
<TD class="tr13 td1"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td3"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td5"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td6"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td190"><P class="p7 ft24"> </P></TD>
<TD colspan=2 rowspan=2 class="tr9 td197"><P class="p23 ft13">Right Ear</P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td54"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD colspan=5 rowspan=2 class="tr9 td198"><P class="p45 ft13">NORMAL</P></TD>
<TD class="tr13 td41"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td199"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD colspan=4 rowspan=2 class="tr9 td200"><P class="p39 ft13">NORMAL</P></TD>
<TD colspan=2 rowspan=2 class="tr9 td144"><P class="p16 ft44"></P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td194"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD class="tr4 td21"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td201"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td140"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td170"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td111"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td112"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td114"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td46"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td136"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td116"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td113"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td138"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td144"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td122"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td50"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td42"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td155"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD class="tr10 td169"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td171"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td45"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr10 td203"><P class="p45 ft13">Other</P></TD>
<TD class="tr10 td170"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td39"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr10 td204"><P class="p16 ft13">Normal<SPAN class="ft45"></SPAN></P></TD>
<TD class="tr10 td114"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr10 td205"><P class="p20 ft13">Abnormal</P></TD>
<TD class="tr10 td138"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr10 td197"><P class="p23 ft13">Left Ear</P></TD>
<TD class="tr10 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td144"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td47"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr10 td198"><P class="p45 ft13">NORMAL</P></TD>
<TD class="tr10 td122"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td202"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td50"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td44"><P class="p7 ft6"> </P></TD>
<TD colspan=4 class="tr10 td200"><P class="p39 ft13">NORMAL</P></TD>
<TD colspan=2 class="tr10 td144"><P class="p16 ft46"></P></TD>
<TD class="tr10 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr10 td155"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=2 class="tr18 td63"><P class="p22 ft47">Systemic</P></TD>
<TD colspan=7 class="tr18 td206"><P class="p30 ft47">Examination</P></TD>
<TD class="tr18 td195"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td207"><P class="p18 ft49">Norm</P></TD>
<TD colspan=2 class="tr18 td188"><P class="p13 ft49">Abnor</P></TD>
<TD class="tr18 td1"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td2"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td3"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td4"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td5"><P class="p7 ft48"> </P></TD>
<TD colspan=5 class="tr18 td208"><P class="p13 ft47">Notes</P></TD>
<TD class="tr18 td4"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td54"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td20"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td209"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td38"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td16"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td40"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td37"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td41"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td6"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td18"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td4"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td81"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td14"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td19"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td10"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td210"><P class="p7 ft48"> </P></TD>
<TD colspan=3 class="tr18 td211"><P class="p47 ft49">Norm</P></TD>
<TD colspan=3 class="tr18 td212"><P class="p32 ft49">Abnor</P></TD>
</TR>
<TR>
<TD colspan=5 rowspan=2 class="tr9 td131"><P class="p48 ft15">Head & Neck</P></TD>
<TD class="tr15 td132"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td133"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td195"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td207"><P class="p13 ft50">NORM</P></TD>
<TD class="tr15 td12"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td199"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td3"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td5"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td7"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td8"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td9"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td209"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td38"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD colspan=7 rowspan=2 class="tr9 td205"><P class="p24 ft2">Respiratory system</P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td210"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td211"><P class="p45 ft50">NORM</P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr4 td140"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td110"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td184"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td213"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td112"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td202"><P class="p7 ft10"> </P></TD>
<TD class="tr3 td1"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td2"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td3"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td5"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td6"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td7"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td8"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td9"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td10"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td54"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td209"><P class="p7 ft9"> </P></TD>
<TD class="tr4 td121"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td44"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td149"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td184"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td48"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td155"><P class="p7 ft10"> </P></TD>
</TR>
<TR>
<TD colspan=3 rowspan=2 class="tr18 td159"><P class="p48 ft2">Eyes</P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td132"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td133"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td195"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td207"><P class="p13 ft50">NORM</P></TD>
<TD class="tr15 td12"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td199"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td3"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td5"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td7"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td8"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td9"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td209"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td38"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD colspan=8 rowspan=2 class="tr18 td131"><P class="p24 ft15">Cardiovascular system</P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td210"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td211"><P class="p32 ft50">NORM</P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td140"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td110"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td213"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td112"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr4 td1"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td2"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td3"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td5"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td6"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td7"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td8"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td9"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td10"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td54"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td20"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td209"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td121"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td149"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td48"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td155"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD colspan=9 rowspan=2 class="tr18 td123"><P class="p48 ft2">Ears / Nose / Throat</P></TD>
<TD class="tr15 td195"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td207"><P class="p13 ft50">NORM</P></TD>
<TD class="tr15 td12"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td199"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td3"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td5"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td7"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td8"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td9"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td209"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td38"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD colspan=4 rowspan=2 class="tr18 td214"><P class="p24 ft2">Per abdomen</P></TD>
<TD class="tr15 td18"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td81"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td210"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td211"><P class="p32 ft50">NORM</P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td213"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td112"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr4 td1"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td2"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td3"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td5"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td6"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td7"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td8"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td9"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td10"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td54"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td20"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td209"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td121"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td50"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td42"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td149"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td48"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td155"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD colspan=9 rowspan=2 class="tr18 td123"><P class="p48 ft2">Teeth / Oral Cavity</P></TD>
<TD class="tr16 td195"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td207"><P class="p13 ft51">NORM</P></TD>
<TD class="tr16 td12"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td199"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td1"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td2"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td3"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td5"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td6"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td7"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td8"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td9"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td10"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td54"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td20"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td209"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td38"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td16"><P class="p7 ft27"> </P></TD>
<TD colspan=7 rowspan=2 class="tr18 td205"><P class="p24 ft15"><NOBR>Genito-urinary</NOBR> system</P></TD>
<TD class="tr16 td14"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td19"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td10"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td210"><P class="p7 ft27"> </P></TD>
<TD colspan=3 class="tr16 td211"><P class="p32 ft51">NORM</P></TD>
<TD class="tr16 td17"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td194"><P class="p7 ft27"> </P></TD>
</TR>
<TR>
<TD class="tr4 td184"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td213"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td112"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td202"><P class="p7 ft10"> </P></TD>
<TD class="tr3 td1"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td2"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td3"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td5"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td6"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td7"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td8"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td9"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td10"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td54"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td209"><P class="p7 ft9"> </P></TD>
<TD class="tr4 td121"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td44"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td149"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td184"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td48"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td155"><P class="p7 ft10"> </P></TD>
</TR>
<TR>
<TD colspan=9 rowspan=2 class="tr11 td123"><P class="p48 ft2"><NOBR>Musculo-Skeletal</NOBR> system</P></TD>
<TD class="tr16 td195"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td207"><P class="p13 ft51">NORM</P></TD>
<TD class="tr16 td12"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td199"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td1"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td2"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td3"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td5"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td6"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td7"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td8"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td9"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td10"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td54"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td20"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td209"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td38"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td16"><P class="p7 ft27"> </P></TD>
<TD colspan=4 rowspan=2 class="tr11 td214"><P class="p24 ft2">Others</P></TD>
<TD class="tr16 td18"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td81"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td14"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td19"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td10"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td210"><P class="p7 ft27"> </P></TD>
<TD colspan=3 class="tr16 td211"><P class="p32 ft51">NORM</P></TD>
<TD class="tr16 td17"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td4"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td194"><P class="p7 ft27"> </P></TD>
</TR>
<TR>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td213"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td112"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr4 td1"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td2"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td3"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td5"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td6"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td7"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td8"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td9"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td10"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td54"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td20"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td209"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td121"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td50"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td42"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td149"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td48"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td155"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD colspan=9 rowspan=2 class="tr18 td123"><P class="p48 ft2">Nervous system</P></TD>
<TD class="tr15 td195"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td207"><P class="p13 ft50">NORM</P></TD>
<TD class="tr15 td12"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td199"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td3"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td5"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td7"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td8"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td9"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td209"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td38"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD colspan=7 rowspan=2 class="tr18 td205"><P class="p24 ft2">Hernia / Hydrocoele</P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td210"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td211"><P class="p32 ft50">NORM</P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td213"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td112"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr4 td1"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td2"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td3"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td5"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td6"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td7"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td8"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td9"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td10"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td54"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td20"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td209"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td121"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td149"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td48"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td155"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD colspan=3 rowspan=2 class="tr18 td159"><P class="p48 ft2">Reflexes</P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td132"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td133"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td195"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td207"><P class="p13 ft50">NORM</P></TD>
<TD class="tr15 td12"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td199"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td3"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td5"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td7"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td8"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td9"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td209"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td38"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD colspan=7 rowspan=2 class="tr18 td205"><P class="p24 ft2">Varicose Veins</P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td210"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td211"><P class="p32 ft50">NORM</P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td140"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td110"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td213"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td112"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td202"><P class="p7 ft8"> </P></TD>
<TD class="tr4 td1"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td2"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td3"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td5"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td6"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td7"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td8"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td9"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td10"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td4"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td54"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td20"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td209"><P class="p7 ft10"> </P></TD>
<TD class="tr2 td121"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td39"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td44"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td45"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td149"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td43"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td47"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td184"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td48"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td49"><P class="p7 ft8"> </P></TD>
<TD class="tr2 td155"><P class="p7 ft8"> </P></TD>
</TR>
<TR>
<TD colspan=3 rowspan=2 class="tr9 td159"><P class="p48 ft2">Skin</P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td132"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td133"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td195"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td207"><P class="p13 ft50">NORM</P></TD>
<TD class="tr15 td12"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td199"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td1"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td3"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td5"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td7"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td8"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td9"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td209"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td38"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD colspan=7 rowspan=2 class="tr9 td205"><P class="p24 ft2">Fissure/Fistula/Piles</P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td210"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td211"><P class="p32 ft50">NORM</P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td140"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td110"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td184"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td213"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td112"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td202"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td114"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td46"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td136"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td116"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td113"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td161"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td117"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td118"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td144"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td182"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td121"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td44"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td149"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td43"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td184"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td48"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td155"><P class="p7 ft10"> </P></TD>
</TR>
<TR>
<TD colspan=9 class="tr9 td123"><P class="p28 ft52">Investigations</P></TD>
<TD class="tr9 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td111"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td112"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td114"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td136"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td116"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td161"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td117"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td118"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td144"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td121"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td145"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td122"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td50"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td44"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td48"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td155"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr18 td159"><P class="p18 ft53">Blood</P></TD>
<TD class="tr18 td47"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td49"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td215"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td49"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td39"><P class="p7 ft48"> </P></TD>
<TD colspan=4 class="tr18 td216"><P class="p49 ft53">Result</P></TD>
<TD class="tr18 td113"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td114"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td46"><P class="p7 ft48"> </P></TD>
<TD colspan=4 class="tr18 td175"><P class="p23 ft53">Normal</P></TD>
<TD class="tr18 td138"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td117"><P class="p7 ft48"> </P></TD>
<TD colspan=2 class="tr18 td172"><P class="p12 ft53">Urine</P></TD>
<TD class="tr18 td49"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td144"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td173"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td120"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td121"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td39"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td145"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td120"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td122"><P class="p7 ft48"> </P></TD>
<TD class="tr18 td202"><P class="p7 ft48"> </P></TD>
<TD class="tr9 td18"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td81"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td19"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td194"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td159"><P class="p18 ft23">Hemoglobin</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td172"><P class="p19 ft54"><?=$customer['hemoglobin']?> GM/DL</P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td141"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td158"><P class="p19 ft23">Colour</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td144"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td173"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD colspan=6 class="tr13 td217"><P class="p18 ft17">PALE YELLOW</P></TD>
<TD class="tr11 td18"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td81"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td19"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td10"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td2"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td16"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td17"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td194"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=5 class="tr13 td218"><P class="p28 ft23">Total WBC Count</P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=6 class="tr13 td219"><P class="p19 ft54"><?=$customer['wbc']?> CELLS/CUMM</P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD colspan=6 class="tr13 td220"><P class="p19 ft23">Specific Gravity</P></TD>
<TD colspan=3 class="tr13 td118"><P class="p50 ft17">1.005</P></TD>
<TD class="tr13 td145"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td202"><P class="p7 ft24"> </P></TD>
<TD class="tr11 td18"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td81"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td19"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td10"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td2"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td16"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td17"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td194"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr15 td221"><P class="p30 ft21">Neu</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td140"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td110"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td112"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td46"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td116"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td158"><P class="p30 ft22">pH</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td173"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD colspan=4 class="tr15 td222"><P class="p18 ft55">ACIDIC</P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td202"><P class="p7 ft19"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td17"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td194"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=5 class="tr13 td218"><P class="p28 ft23">Malarial parasite</P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td172"><P class="p7 ft54"><NOBR>-VE</NOBR></P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td112"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td158"><P class="p19 ft23">Albumin</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td144"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td173"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD colspan=4 class="tr13 td222"><P class="p18 ft17">NIL</P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td202"><P class="p7 ft24"> </P></TD>
<TD class="tr11 td18"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td81"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td19"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td10"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td2"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td16"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td17"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td194"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr15 td221"><P class="p28 ft22">ESR</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td215"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td172"><P class="p19 ft40"><?=$customer['esr']?> MM/HR</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td46"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td116"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td158"><P class="p19 ft22">Sugar</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td173"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD colspan=4 class="tr15 td222"><P class="p18 ft55">NIL</P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td202"><P class="p7 ft19"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td17"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td194"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td221"><P class="p28 ft23">SGPT</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=2 class="tr13 td46"><P class="p7 ft54"><?=$customer['sgpt']?></P></TD>
<TD class="tr13 td110"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td141"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td158"><P class="p19 ft23">Bile Pigment</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td144"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td173"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD colspan=4 class="tr13 td222"><P class="p18 ft17">NIL</P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td202"><P class="p7 ft24"> </P></TD>
<TD class="tr11 td18"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td81"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td19"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td10"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td2"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td16"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td17"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td194"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr15 td221"><P class="p28 ft22">S.Cholesterol</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td215"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr15 td46"><P class="p7 ft40"><?=$customer['cholestrol']?></P></TD>
<TD class="tr15 td110"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td46"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td116"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td158"><P class="p19 ft22">Bile Salts</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td173"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD colspan=4 class="tr15 td222"><P class="p18 ft55">NIL</P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td202"><P class="p7 ft19"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td17"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td194"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr15 td221"><P class="p28 ft22">S.Triglycerides</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td215"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td110"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td141"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td46"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td116"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td158"><P class="p19 ft22">Occult Blood</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td173"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD colspan=4 class="tr15 td222"><P class="p18 ft55"><NOBR>-VE</NOBR></P></TD>
<TD class="tr15 td122"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td202"><P class="p7 ft19"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td17"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td194"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td221"><P class="p28 ft23">Blood Sugar</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=2 class="tr13 td46"><P class="p7 ft54"><?=$customer['sugar']?></P></TD>
<TD class="tr13 td110"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td141"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td158"><P class="p19 ft23">RBC Cells</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td144"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td173"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD colspan=4 class="tr13 td222"><P class="p18 ft17">NIL</P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td202"><P class="p7 ft24"> </P></TD>
<TD class="tr11 td18"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td81"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td19"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td10"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td2"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td14"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td20"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td16"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td17"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td4"><P class="p7 ft14"> </P></TD>
<TD class="tr11 td194"><P class="p7 ft14"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr15 td221"><P class="p28 ft22">Hbsaq</P></TD>
<TD class="tr15 td47"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td215"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td172"><P class="p7 ft55">NEGATIVE</P></TD>
<TD class="tr15 td39"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td111"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td112"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td114"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td46"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td136"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td116"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td113"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td138"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td158"><P class="p19 ft22">Leucocvtes</P></TD>
<TD class="tr15 td49"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td144"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td173"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td120"><P class="p7 ft19"> </P></TD>
<TD colspan=6 class="tr15 td217"><P class="p18 ft55"><NOBR>1-2</NOBR> PUSCELLS</P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td17"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td194"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td221"><P class="p28 ft23">HIV I & II</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td172"><P class="p7 ft17">NEGATIVE</P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td112"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td158"><P class="p19 ft23">Others</P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td144"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td173"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td121"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td145"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td120"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td202"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td50"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td42"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td43"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td44"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td45"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td43"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td48"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td155"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr16 td221"><P class="p28 ft26">VDRL</P></TD>
<TD class="tr16 td47"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td49"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td215"><P class="p7 ft27"> </P></TD>
<TD colspan=3 class="tr16 td172"><P class="p7 ft38">NEGATIVE</P></TD>
<TD class="tr16 td39"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td111"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td112"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td113"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td114"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td46"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td136"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td49"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td116"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td113"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td138"><P class="p7 ft27"> </P></TD>
<TD colspan=3 rowspan=2 class="tr17 td158"><P class="p19 ft56">Spirometry</P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td54"><P class="p7 ft19"> </P></TD>
<TD colspan=6 rowspan=2 class="tr17 td223"><P class="p51 ft2">NOT DONE</P></TD>
<TD class="tr15 td41"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td18"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td81"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td19"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td10"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td2"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td14"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td20"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td16"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td17"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td194"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td221"><P class="p12 ft23">Others</P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td215"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td172"><P class="p7 ft17">NIL</P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td111"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td112"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td114"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td136"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td116"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td138"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td144"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td122"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td113"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td50"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td42"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td43"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td44"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td45"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td46"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td43"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td47"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td39"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td48"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td49"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td155"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr13 td56"><P class="p28 ft23">Blood Group</P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td224"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD colspan=2 class="tr13 td225"><P class="p7 ft54"><?=$customer['blood_group']?></P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td52"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td12"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td6"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td1"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td3"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td5"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td6"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td190"><P class="p7 ft24"> </P></TD>
<TD colspan=3 class="tr13 td55"><P class="p19 ft25">Drugs of</P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td54"><P class="p7 ft24"> </P></TD>
<TD colspan=6 rowspan=3 class="tr19 td15"><P class="p9 ft2">NOT DONE</P></TD>
<TD class="tr13 td41"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td6"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td81"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td19"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td10"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td14"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td20"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td16"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td17"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td4"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td18"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD class="tr4 td169"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td117"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td45"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td47"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td215"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td110"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td39"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td111"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td112"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td113"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td114"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td46"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td136"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td49"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td116"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td113"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td138"><P class="p7 ft10"> </P></TD>
<TD colspan=3 rowspan=3 class="tr11 td55"><P class="p19 ft57">Abuse</P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td54"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td41"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td6"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td18"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td81"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td14"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td19"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td10"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td2"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td14"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td16"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td17"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td18"><P class="p7 ft9"> </P></TD>
</TR>
<TR>
<TD colspan=3 rowspan=3 class="tr18 td159"><P class="p23 ft47">ECG</P></TD>
<TD class="tr14 td20"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td4"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td132"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td4"><P class="p7 ft18"> </P></TD>
<TD colspan=6 rowspan=3 class="tr18 td226"><P class="p20 ft2">NOT DONE</P></TD>
<TD class="tr14 td1"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td2"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td3"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td4"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td5"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td6"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td190"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td4"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td54"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td41"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td6"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td18"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td4"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td81"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td14"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td19"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td10"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td2"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td14"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td20"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td16"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td17"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td4"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td18"><P class="p7 ft18"> </P></TD>
</TR>
<TR>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td132"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td1"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td2"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td3"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td5"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td6"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td190"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td54"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td37"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td38"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td16"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td40"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td37"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td41"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td6"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td18"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td81"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td14"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td19"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td10"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td2"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td14"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td20"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td16"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td17"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td4"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td18"><P class="p7 ft9"> </P></TD>
</TR>
<TR>
<TD class="tr20 td47"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td49"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td140"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td49"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td114"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td46"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td136"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td49"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td116"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td113"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td138"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td117"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td118"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td45"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td49"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td144"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td47"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td120"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td121"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td39"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td145"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td120"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td122"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td113"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td50"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td49"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td42"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td43"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td44"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td45"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td46"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td43"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td47"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td39"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td48"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td49"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td50"><P class="p7 ft58"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr7 td159"><P class="p28 ft12"><NOBR>X-Ray</NOBR></P></TD>
<TD colspan=10 class="tr7 td227"><P class="p7 ft2"><SPAN class="ft12">Chest </SPAN>NOT DONE</P></TD>
<TD class="tr7 td114"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td136"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td116"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td138"><P class="p7 ft6"> </P></TD>
<TD colspan=3 class="tr7 td158"><P class="p19 ft30">USG</P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td144"><P class="p7 ft6"> </P></TD>
<TD colspan=6 class="tr7 td223"><P class="p9 ft2">NOT DONE</P></TD>
<TD class="tr7 td122"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td50"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td44"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td48"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr7 td50"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=13 class="tr9 td228"><P class="p52 ft59">RESULT OF MEDICAL EXAMINATION</P></TD>
<TD class="tr9 td114"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td136"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td116"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td161"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td117"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td118"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td144"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td121"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td145"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td120"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td122"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td113"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td50"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td42"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td44"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td45"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td43"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td47"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td39"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td48"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td49"><P class="p7 ft6"> </P></TD>
<TD class="tr9 td50"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr5 td159"><P class="p30 ft13">Fit <SPAN class="ft60"></SPAN></P></TD>
<TD colspan=6 class="tr5 td229"><P class="p24 ft13">Unfit<SPAN class="ft60"></SPAN></P></TD>
<TD colspan=4 class="tr5 td230"><P class="p39 ft13">Temporarily Unfit<SPAN class="ft60"></SPAN></P></TD>
<TD class="tr5 td114"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td46"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td136"><P class="p7 ft6"> </P></TD>
<TD colspan=7 class="tr5 td231"><P class="p7 ft13">Permanently Unfit<SPAN class="ft60"></SPAN></P></TD>
<TD colspan=10 class="tr5 td157"><P class="p7 ft13">Should be <NOBR>re-examined</NOBR> in</P></TD>
<TD class="tr5 td50"><P class="p7 ft6"> </P></TD>
<TD colspan=12 class="tr5 td232"><P class="p53 ft61">days / weeks / months.</P></TD>
</TR>
<TR>
<TD colspan=9 class="tr6 td51"><P class="p20 ft13">Remarks/Recommendation:</P></TD>
<TD class="tr6 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td52"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td12"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td1"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td3"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td5"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td7"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td9"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td54"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td37"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td38"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td37"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td18"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td81"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td19"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td10"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td14"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td20"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td17"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td18"><P class="p7 ft6"> </P></TD>
</TR>
</TABLE>
<P class="p54 ft59">I Dr. Ushas Kumar G, certify that all information required under annexure E & F M.S. (Medical Examination) Rules 2000 is incorporated in this certificate.</P>
<P class="p55 ft13">This Certificate is Valid till 14/11/2021</P>
<TABLE cellpadding=0 cellspacing=0 class="t1">
<TR>
<TD class="tr6 td233"><P class="p7 ft0">Candidate’s Signature</P></TD>
<TD rowspan=2 class="tr17 td234"><P class="p7 ft13">Doctor’s Signature</P></TD>
</TR>
<TR>
<TD class="tr3 td233"><P class="p7 ft9"> </P></TD>
</TR>
<TR>
<TD class="tr17 td233"><P class="p7 ft0">Date:<?php echo date('d-m-Y');?></P></TD>
<TD class="tr17 td234"><P class="p7 ft6"> </P></TD>
</TR>
</TABLE>
</DIV>
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