%PDF-
%PDF-
Mini Shell
Mini Shell
<style>
.ht{
height:250px;
}
</style>
<link href="<?php echo base_url().'assets/css/formstyle.css'?>" rel="stylesheet" type="text/css"/>
<div class="content-wrapper">
<section class="content-header">
<h1>Dashboard</h1>
</section>
<section class="content">
<div class="container">
<div class="row">
<div class="col-sm-3">
<div class="card card-primary card-outline ht">
<div class="card-body box-profile">
<div class="text-center">
<img class="profile-user-img img-fluid img-circle" src="http://localhost/BOS/assets//dist/img/user4-128x128.jpg" alt="User profile picture">
</div>
<h3 class="profile-username text-center"><?=$customer['customer_name']?></h3>
<p class="text-muted text-center"><?=$customer['lead_id']?></p>
</div>
<!-- /.card-body -->
</div>
</div>
<div class="col-sm-9">
<div class="card card-primary card-outline ht">
<div class="card-body box-profile">
<div class="row">
<div class="col-md-6">
<p class="text-muted "><span class="detailtxt">Location: </span><?=$customer['location']?> </p>
<p class="text-muted ">Mobile: <?=$customer['mobile_no']?> </p>
<p class="text-muted ">Email: <?=$customer['email']?> </p>
</div>
<div class="col-md-6">
<p class="text-muted ">Gender: <?=$customer['gender']?> </p>
<p class="text-muted ">Dob: <?=$customer['dob']?> </p>
<p class="text-muted ">Added Date: <?=$customer['added_date']?> </p>
<p class="text-muted ">Enquiry Source: <?=$customer['enquiry_source']?> </p>
<a href="<?php echo base_url();?>emp/all/<?=$customer['lead_id']?>" class="btn btn-danger btn-sm" >Generate All Pdf</a>
</div>
</div>
</div>
<!-- /.card-body -->
</div>
</div>
</div>
<div class="row">
<div class="col-md-12">
<!--<a href="#" class="btn btn-danger btn-sm" data-toggle="modal" data-target="#myModal">Add Remark</a> -->
<div class="card">
<div class="card-header p-2">
<ul class="nav nav-pills">
<li class="nav-item"><a class="nav-link active" href="#timeline" data-toggle="tab">Medical Examination Report</a></li>
<li class="nav-item"><a class="nav-link" href="#seaservice" data-toggle="tab">Sea Service Certificate</a></li>
<li class="nav-item"><a class="nav-link" href="#settings" data-toggle="tab">Sight Test Certificate</a></li>
</ul>
</div><!-- /.card-header -->
<div class="card-body">
<div class="tab-content">
<!-- /.tab-pane -->
<div class="active tab-pane" id="timeline">
<a href="<?php echo base_url();?>emp/pdf/<?=$customer['lead_id']?>" class="btn btn-danger btn-sm" >Generate Pdf</a>
<DIV id="page_1">
<DIV id="p1dimg1">
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id="p1img1"></DIV>
<P class="p0 ft0">Reg no...........................</P>
<div class="borders1">
<P class="p1 ft1">REPORT OF MEDICAL EXAMINATION OF SEAFARER BY AN APPROVED MEDICAL EXAMINER.</P>
<P class="p2 ft2">As per Merchant Shipping (Medical Examination) Rules 2000 and ISM / STCW code 1/9 and ILO covention 147</P>
</div>
<div class="borders1">
<P class="p3 ft3"><NOBR>HI-CARE</NOBR> <NOBR>MEDI-CENTRE</NOBR></P>
<P class="p4 ft0">Door No. 39/1492,1<SPAN class="ft4">st </SPAN>Floor, Kalathiparampil Cross Road, Ernakulam South, Cochin - 682016.</P>
<P class="p5 ft0">Phone : <NOBR>0484-2375557,</NOBR> 9895209326</P>
</div>
<TABLE cellpadding=0 cellspacing=0 class="t0">
<TR>
<TD colspan=13 rowspan=2 class="tr0 td0"><P class="p6 ft5">Name: <?=$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: <?=$customer['gender']?></P></TD>
<TD colspan=3 rowspan=2 class="tr0 td12"><P class="p9 ft5"></P></TD>
<TD colspan=5 rowspan=2 class="tr0 td13"><P class="p10 ft5">Serial No:</P></TD>
<TD class="tr1 td14"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr1 td15"><P class="p11 ft7"><?=$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><?php echo date("d-m-Y", strtotime($customer['dob']));?></NOBR></P></TD>
<TD class="tr5 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td52"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td12"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td6"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td1"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td3"><P class="p7 ft6"> </P></TD>
<TD class="tr5 td4"><P class="p7 ft6"> </P></TD>
<TD colspan=6 class="tr5 td53"><P class="p13 ft5">PP/CDC: <?=$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"><?=$customer['ecg']?></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><?=$customer['xray']?></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</P></TD>
<TD colspan=4 class="tr5 td230"><P class="p39 ft13">Temporarily Unfit</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</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>
<?php
$date = strtotime($customer['added_date']);
$newdate = date('d-m-Y',strtotime("+2 year",$date));
$expire = date('d-m-Y',strtotime($newdate . ' -1 day'));
?>
<P class="p55 ft13">This Certificate is Valid till <?=$expire?></P>
<TABLE cellpadding=0 cellspacing=0 class="t1">
<TR>
<TD class="tr6 td233"><P class="p7 ft0">Candidate’s Signature</P></TD>
<TD rowspan=2 class="tr17 td234"><P class="p7 ft13">Doctor’s Signature</P></TD>
</TR>
<TR>
<TD class="tr3 td233"><P class="p7 ft9"> </P></TD>
</TR>
<TR>
<TD class="tr17 td233"><P class="p7 ft0">Date:<?php echo date("d-m-Y", strtotime($customer['added_date']));?></P></TD>
<TD class="tr17 td234"><P class="p7 ft6"> </P></TD>
</TR>
</TABLE>
</DIV>
<!-- The timeline -->
</div>
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<div class="tab-pane" id="seaservice">
<a href="<?php echo base_url();?>emp/pdfseasevice/<?=$customer['lead_id']?>" class="btn btn-danger btn-sm" >Generate Pdf</a>
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<DIV id="p2dimg1">
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id="p2img1"></DIV>
<P class="p56 ft62">Annexure - IV</P>
<P class="p57 ft63">Medical Certificate for Service at Sea</P>
<P class="p58 ft63">[Issued Under the Authority of Directorate General of Shipping, Govt. of India Under Rule No.4 of M.S</P>
<P class="p59 ft63">(Medical Examination) Rules, 2000 as amended]</P>
<P class="p60 ft63"><?=$customer['customer_name']?></P>
<TABLE cellpadding=0 cellspacing=0 class="t2">
<TR>
<TD class="tr6 td235"><P class="p13 ft64"><NOBR><?php echo date("d-m-Y", strtotime($customer['dob']));?></NOBR></P></TD>
<TD class="tr6 td132"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td16"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td236"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td2"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td58"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td237"><P class="p61 ft64"><?=$customer['gender']?></P></TD>
<TD class="tr6 td238"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td239"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD class="tr15 td240"><P class="p7 ft19"> </P></TD>
<TD colspan=3 class="tr15 td241"><P class="p7 ft19"> </P></TD>
<TD class="tr13 td2"><P class="p7 ft24"> </P></TD>
<TD class="tr15 td242"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td243"><P class="p7 ft19"> </P></TD>
<TD class="tr13 td238"><P class="p7 ft24"> </P></TD>
<TD class="tr13 td239"><P class="p7 ft24"> </P></TD>
</TR>
<TR>
<TD colspan=4 class="tr9 td244"><P class="p13 ft65">Date of Birth :( dd/mm/yyyy)</P></TD>
<TD class="tr9 td2"><P class="p7 ft66"> </P></TD>
<TD colspan=2 class="tr9 td245"><P class="p34 ft67">Gender :( Male/Female)</P></TD>
<TD class="tr9 td238"><P class="p7 ft66"> </P></TD>
<TD class="tr9 td239"><P class="p7 ft66"> </P></TD>
</TR>
<TR>
<TD colspan=2 class="tr21 td236"><P class="p13 ft67">Indian Passport / CDC No</P></TD>
<TD colspan=2 class="tr22 td246"><P class="p31 ft64"><?=$customer['passport_no']?></P></TD>
<TD colspan=2 class="tr21 td247"><P class="p13 ft64">Valid until :</P></TD>
<TD colspan=2 class="tr22 td246"><P class="p31 ft64"><?php echo date("d-m-Y", strtotime($customer['passport_validity']));?></P></TD>
<TD class="tr22 td248"><P class="p7 ft6"> </P></TD>
<TD class="tr21 td239"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD class="tr21 td235"><P class="p13 ft67">Has been examined by</P></TD>
<TD class="tr22 td249"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td250"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td251"><P class="p49 ft68">Dr. Ushas Kumar G</P></TD>
<TD colspan=3 class="tr22 td252"><P class="p16 ft68">KRL/ERN/032017</P></TD>
<TD class="tr22 td248"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td253"><P class="p7 ft6"> </P></TD>
</TR>
</TABLE>
<P class="p62 ft64">(Name of the Medical Examiner and Approval No.)</P>
<P class="p63 ft64">And has been found FIT for sea service at sea in the job of.</P>
<P class="p63 ft69">If Unfit / Temp Unfit, Specify Reason-</P>
<hr>
<hr>
<P class="p64 ft64"><SPAN class="ft64">(a)</SPAN><SPAN class="ft70">The hearing and sight of the seafarer concerned, and the colour vision in the case of a seafarer to be employed in capacities where fitness for the work to be performed is liable to be affected by defective colour vision, are all satisfactory; and</SPAN></P>
<P class="p65 ft64"><SPAN class="ft64">(b)</SPAN><SPAN class="ft71">The seafarer concerned is not suffering from any medical condition likely to be aggravated by service at sea or to render the seafarer unfit for such service or to endanger the health of other persons on board.</SPAN></P>
<P class="p66 ft67"><SPAN class="ft67">(c)</SPAN><SPAN class="ft72">The Seafarer complies with the requirements specified in Table </SPAN><NOBR>A-I/9</NOBR> of STCW Code (i.e. Minimum in service eyesight standards for seafarers), Table <NOBR>B-I/9</NOBR> of the STCW Code (i.e. Assessment of minimum entry level and <NOBR>in-service</NOBR> physical abilities for seafarers) and Regulation 1.2, Standard <NOBR>A-1.2</NOBR> & Guideline <NOBR>B-1.2</NOBR> of the Maritime Labour Convention 2006.</P>
<TABLE cellpadding=0 cellspacing=0 class="t3">
<TR>
<TD colspan=2 class="tr6 td254"><P class="p67 ft64"><?php echo date("d-m-Y", strtotime($customer['added_date']));?></P></TD>
<TD colspan=4 class="tr6 td236"><P class="p8 ft64">KOCHI</P></TD>
<TD class="tr6 td255"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td256"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD class="tr20 td257"><P class="p7 ft58"> </P></TD>
<TD colspan=2 class="tr20 td258"><P class="p7 ft58"> </P></TD>
<TD class="tr20 td259"><P class="p7 ft58"> </P></TD>
<TD class="tr23 td40"><P class="p7 ft73"> </P></TD>
<TD class="tr23 td260"><P class="p7 ft73"> </P></TD>
<TD class="tr23 td255"><P class="p7 ft73"> </P></TD>
<TD class="tr23 td256"><P class="p7 ft73"> </P></TD>
</TR>
<TR>
<TD class="tr14 td40"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td261"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td41"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td11"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td40"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td260"><P class="p7 ft18"> </P></TD>
<TD class="tr14 td255"><P class="p7 ft18"> </P></TD>
<TD class="tr8 td262"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD colspan=6 class="tr6 td263"><P class="p24 ft64">(Date & Place of Medical Examination)</P></TD>
<TD class="tr6 td255"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td256"><P class="p21 ft64">(Signature of the Medical Examiner)</P></TD>
</TR>
<TR>
<TD colspan=2 class="tr22 td254"><P class="p68 ft64"><?=$customer['lead_id']?></P></TD>
<TD class="tr22 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td11"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td260"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td255"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td256"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD class="tr15 td40"><P class="p7 ft19"> </P></TD>
<TD colspan=2 class="tr16 td258"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td259"><P class="p7 ft27"> </P></TD>
<TD class="tr16 td257"><P class="p7 ft27"> </P></TD>
<TD class="tr15 td260"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td255"><P class="p7 ft19"> </P></TD>
<TD class="tr15 td256"><P class="p7 ft19"> </P></TD>
</TR>
<TR>
<TD class="tr6 td40"><P class="p7 ft6"> </P></TD>
<TD colspan=5 class="tr6 td264"><P class="p22 ft64">(Serial number of the Certificate)</P></TD>
<TD class="tr6 td255"><P class="p7 ft6"> </P></TD>
<TD class="tr6 td256"><P class="p7 ft6"> </P></TD>
</TR>
<TR>
<TD class="tr22 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td261"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td11"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td260"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td11"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr22 td265"><P class="p52 ft68">Address:</P></TD>
</TR>
<TR>
<TD colspan=6 class="tr21 td263"><P class="p24 ft64"><NOBR><SPAN class="ft68">E-mail</SPAN></NOBR><SPAN class="ft68"> ID: </SPAN>ushaskumar7@gmail.com</P></TD>
<TD class="tr22 td260"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr21 td265"><P class="p52 ft64">Door No. 39/1492, 1st Floor, Kalathiparampil Cross Road,</P></TD>
</TR>
<TR>
<TD class="tr22 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td261"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td41"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td11"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td40"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td260"><P class="p7 ft6"> </P></TD>
<TD class="tr22 td260"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr22 td265"><P class="p52 ft64">Ernakulam South, Cochin - 682016.</P></TD>
</TR>
<TR>
<TD colspan=6 class="tr21 td263"><P class="p24 ft64"><SPAN class="ft68">Contact No: </SPAN>+91 9895209326</P></TD>
<TD class="tr22 td260"><P class="p7 ft6"> </P></TD>
<TD colspan=2 class="tr21 td265"><P class="p52 ft64">Phone: <NOBR>0484-2375557,</NOBR> 9895209326</P></TD>
</TR>
<?php
$date = strtotime($customer['added_date']);
$newdate = date('d-m-Y',strtotime("+2 year",$date));
$expire = date('d-m-Y',strtotime($newdate . ' -1 day'));
?>
<TR>
<TD colspan=6 class="tr24 td263"><P class="p45 ft64">This Certificate expires on* <?=$expire?></P></TD>
<TD colspan=2 class="tr24 td265"><P class="p21 ft64">Official Stamp of the Medical Examiner</P></TD>
</TR>
<TR>
<TD class="tr3 td40"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td261"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td41"><P class="p7 ft9"> </P></TD>
<TD class="tr4 td259"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td257"><P class="p7 ft10"> </P></TD>
<TD class="tr4 td266"><P class="p7 ft10"> </P></TD>
<TD class="tr3 td255"><P class="p7 ft9"> </P></TD>
<TD class="tr3 td256"><P class="p7 ft9"> </P></TD>
</TR>
</TABLE>
<P class="p69 ft64">(Day, Month, Year)*</P>
<P class="p70 ft69">(* Not more than 2 years from the date of issue, unless the seafarers is under the age of 18, in which case the maximum period of validity of the Medical Certificate shall be 1 year).</P>
<P class="p71 ft69">If the period of validity of the medical certificate expires in the course of voyage, the medical certificate shall continue in force until the next port of call where an approved Medical Examiner is available and the seafarer can obtain a medical certificate, provided that period of such extension shall not exceed 3 months.</P>
</DIV>
</div>
<div class="tab-pane" id="settings">
<a href="<?php echo base_url();?>emp/pdfeyetest/<?=$customer['lead_id']?>" class="btn btn-danger btn-sm" >Generate Pdf</a>
<DIV id="page_3">
<DIV id="p3dimg1">
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id="p3img1"></DIV>
<TABLE cellpadding=0 cellspacing=0 class="t4">
<TR>
<TD class="tr22 td267"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td268"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td269"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td17"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td237"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td271"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td4"><P class="p7 ft74"> </P></TD>
<TD colspan=4 class="tr22 td53"><P class="p24 ft75">Appendix– V</P></TD>
</TR>
<TR>
<TD class="tr22 td272"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td273"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td274"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td275"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td243"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td276"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td277"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td278"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td279"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td280"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td281"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td282"><P class="p7 ft74"> </P></TD>
<TD class="tr22 td283"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr25 td267"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td268"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td269"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td17"><P class="p7 ft74"> </P></TD>
<TD colspan=4 class="tr25 td284"><P class="p43 ft76">SIGHT TEST CERTIFICATE</P></TD>
<TD class="tr25 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td285"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr25 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr10 td267"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td268"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td269"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td17"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td237"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr10 td51"><P class="p72 ft77">New Entry*/Periodic*</P></TD>
<TD class="tr10 td271"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td285"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr10 td272"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td273"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td274"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td275"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td243"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td276"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td277"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td278"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td279"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td280"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td281"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td282"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td283"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td286"><P class="p23 ft78">Reference No.</P></TD>
<TD class="tr6 td287"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td237"><P class="p13 ft78"><?=$customer['lead_id']?></P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD colspan=3 class="tr6 td289"><P class="p8 ft79">Form B :</P></TD>
</TR>
<TR>
<TD class="tr16 td272"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td273"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td290"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td243"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td291"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td279"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td281"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td282"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td283"><P class="p7 ft80"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td286"><P class="p23 ft78">Full Name</P></TD>
<TD class="tr6 td287"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td292"><P class="p13 ft78"><?=$customer['customer_name']?></P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td285"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr2 td267"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td268"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td269"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td287"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td237"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td56"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td270"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td288"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td4"><P class="p7 ft81"> </P></TD>
<TD class="tr2 td8"><P class="p7 ft81"> </P></TD>
<TD class="tr14 td281"><P class="p7 ft82"> </P></TD>
<TD class="tr14 td282"><P class="p7 ft82"> </P></TD>
<TD class="tr2 td6"><P class="p7 ft81"> </P></TD>
</TR>
<TR>
<TD class="tr20 td272"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td273"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td274"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td290"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td243"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td276"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td277"><P class="p7 ft83"> </P></TD>
<TD class="tr20 td291"><P class="p7 ft83"> </P></TD>
<TD class="tr23 td4"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td293"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td285"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td294"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td6"><P class="p7 ft84"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td286"><P class="p23 ft78">Rank</P></TD>
<TD class="tr6 td287"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td292"><P class="p13 ft78"><?=$customer['rank']?></P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td293"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td285"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td294"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr16 td272"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td273"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td290"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td243"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td291"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td293"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td285"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td294"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td286"><P class="p23 ft78">PP/CDC/ ID No.</P></TD>
<TD class="tr6 td287"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td237"><P class="p13 ft78"><?=$customer['passport_no']?></P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td293"><P class="p7 ft74"> </P></TD>
<TD colspan=2 rowspan=2 class="tr21 td295"><P class="p31 ft86">Photograph</P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr16 td272"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td273"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td290"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td243"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td291"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td293"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td286"><P class="p23 ft87">Date & Place of Birth</P></TD>
<TD class="tr6 td287"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td237"><P class="p13 ft78"><NOBR><?php echo date("d-m-Y", strtotime($customer['dob']));?></NOBR></P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td293"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td285"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td294"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr16 td272"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td273"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td290"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td243"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td291"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td293"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td285"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td294"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr6 td286"><P class="p23 ft78">Colour of Eyes</P></TD>
<TD class="tr6 td287"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td237"><P class="p13 ft78">BLACK</P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td293"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td285"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td294"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr16 td272"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td273"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td290"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td243"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td291"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td4"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td293"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td285"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td294"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD colspan=3 class="tr19 td286"><P class="p23 ft88">Identification Notes</P></TD>
<TD class="tr19 td287"><P class="p7 ft74"> </P></TD>
<TD class="tr19 td237"><P class="p13 ft78"><?=$customer['identification_notes']?></P></TD>
<TD class="tr19 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr19 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr19 td288"><P class="p7 ft74"> </P></TD>
<TD class="tr19 td4"><P class="p7 ft74"> </P></TD>
<TD class="tr19 td293"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td281"><P class="p7 ft74"> </P></TD>
<TD class="tr10 td296"><P class="p7 ft74"> </P></TD>
<TD class="tr19 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr23 td272"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td273"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td274"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td290"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td243"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td276"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td277"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td291"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td279"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td280"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td281"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td282"><P class="p7 ft84"> </P></TD>
<TD class="tr23 td283"><P class="p7 ft84"> </P></TD>
</TR>
<TR>
<TD class="tr11 td267"><P class="p7 ft89"> </P></TD>
<TD class="tr13 td273"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td274"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td275"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td243"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td276"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td277"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td278"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td279"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td280"><P class="p7 ft90"> </P></TD>
<TD class="tr13 td281"><P class="p7 ft90"> </P></TD>
<TD class="tr11 td37"><P class="p7 ft89"> </P></TD>
<TD class="tr11 td6"><P class="p7 ft89"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td268"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td17"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td298"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td299"><P class="p34 ft91">Right Eye</P></TD>
<TD class="tr6 td300"><P class="p73 ft91">Left Eye</P></TD>
<TD class="tr6 td271"><P class="p74 ft91">Both Eyes</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p14 ft79">Result</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD class="tr16 td273"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td308"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Unaided</P></TD>
<TD class="tr6 td299"><P class="p73 ft78">6/6</P></TD>
<TD class="tr6 td300"><P class="p73 ft78">6/6</P></TD>
<TD class="tr6 td271"><P class="p74 ft78">6/6</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p8 ft78">Normal</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD rowspan=2 class="tr21 td308"><P class="p73 ft77">Distance Vision</P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Aided</P></TD>
<TD class="tr6 td299"><P class="p73 ft78"><?=$customer['drec']?></P></TD>
<TD class="tr6 td300"><P class="p73 ft78"><?=$customer['dlec']?></P></TD>
<TD class="tr6 td271"><P class="p74 ft78">6/6</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p8 ft78">Normal</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD class="tr16 td310"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td308"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Unaided</P></TD>
<TD class="tr6 td299"><P class="p34 ft78"><?=$customer['dreuc']?></P></TD>
<TD class="tr6 td300"><P class="p75 ft78"><?=$customer['dleuc']?></P></TD>
<TD class="tr6 td271"><P class="p74 ft78">N/5</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p8 ft78">Normal</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD rowspan=2 class="tr21 td308"><P class="p73 ft77">Near Vision</P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Aided</P></TD>
<TD class="tr6 td299"><P class="p34 ft78">N/5</P></TD>
<TD class="tr6 td300"><P class="p75 ft78">N/5</P></TD>
<TD class="tr6 td271"><P class="p74 ft78">N/5</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p8 ft78">Normal</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD class="tr16 td310"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td308"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Horizontal Plan</P></TD>
<TD class="tr6 td299"><P class="p34 ft78">Normal</P></TD>
<TD class="tr6 td300"><P class="p73 ft78">Normal</P></TD>
<TD class="tr6 td271"><P class="p74 ft78">Normal</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p8 ft78">Normal</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD rowspan=2 class="tr21 td308"><P class="p73 ft77">Field of Vision</P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Vertical Plan</P></TD>
<TD class="tr6 td299"><P class="p34 ft78">Normal</P></TD>
<TD class="tr6 td300"><P class="p73 ft78">Normal</P></TD>
<TD class="tr6 td271"><P class="p74 ft78">Normal</P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p8 ft78">Normal</P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD class="tr16 td310"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td304"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td305"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td308"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Ishihara</P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p76 ft78">Normal</P></TD>
<TD class="tr6 td271"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD rowspan=2 class="tr21 td308"><P class="p73 ft77">Colour Vision</P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
<TR>
<TD class="tr6 td297"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td269"><P class="p7 ft74"> </P></TD>
<TD colspan=2 class="tr6 td309"><P class="p7 ft78">Lantern / Others</P></TD>
<TD class="tr6 td56"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td270"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td271"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td301"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td8"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td302"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td37"><P class="p7 ft74"> </P></TD>
<TD class="tr6 td6"><P class="p7 ft74"> </P></TD>
</TR>
<TR>
<TD class="tr15 td297"><P class="p7 ft85"> </P></TD>
<TD class="tr16 td310"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td274"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td275"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td303"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td276"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td277"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td278"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td306"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td280"><P class="p7 ft80"> </P></TD>
<TD class="tr16 td307"><P class="p7 ft80"> </P></TD>
<TD class="tr15 td37"><P class="p7 ft85"> </P></TD>
<TD class="tr15 td6"><P class="p7 ft85"> </P></TD>
</TR>
</TABLE>
<P class="p77 ft93">I, <SPAN class="ft92">Dr. Ushas Kumar G</SPAN> hereby certify that the above mentioned candidate has met/not met*, the eye sight standard for his/her designated rank / position as set out in <NOBR>Annex-II* /Annex-</NOBR> III* for seafaring occupation.</P>
<TABLE cellpadding=0 cellspacing=0 class="t5">
<TR>
<TD class="tr1 td311"><P class="p7 ft88">Candidate’s Signature</P></TD>
<TD class="tr1 td312"><P class="p78 ft88">Signature of the Medical Examiner</P></TD>
</TR>
<TR>
<TD class="tr24 td311"><P class="p7 ft88">Date:<?php echo date("d-m-Y", strtotime($customer['added_date']));?></P></TD>
<TD class="tr24 td312"><P class="p7 ft88">at : Kochi</P></TD>
</TR>
</TABLE>
<P class="p79 ft95"><SPAN class="ft94">Note</SPAN>:</P>
<P class="p80 ft98"><SPAN class="ft88">1)</SPAN><SPAN class="ft96">This certificate is valid for </SPAN><SPAN class="ft97">two years</SPAN> from the above date. New entry sight test certificates should be retained by the candidate till his active sea career.</P>
<P class="p81 ft93"><SPAN class="ft88">2)</SPAN><SPAN class="ft99">Seafarer aggrieved by the decision of the Medical Examiner may appeal as per the provision of the M.S. (Medical Examination) Rules, 2000 as amended.</SPAN></P>
<P class="p82 ft88"><SPAN class="ft88">*</SPAN><SPAN class="ft100">Delete if not applicable.</SPAN></P>
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<form id="add-row-form" action="<?php echo site_url('emp/addremark');?>" method="post">
<div id="myModal" class="modal fade" role="dialog">
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<button type="button" class="close" data-dismiss="modal">×</button>
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<input type="hidden" name="lead_id" value="<?=$customer['lead_id']?>">
<div class="form-group">
<label>Enter a Remark</label>
<input type="text" name="remarks" class="form-control" placeholder="" required>
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<option value="<?php echo $row->lead_type_id;?>"><?php echo $row->Lead_type;?></option>
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