外国人体格检查记录 - ichzaueducn
外国人体格检查资料收集-华中农业大学
外国人体格检查记录PHYSICAL EXAMINATION RECORD FOR FOREIGNER体检说明EXPLANATION OF THE PHYSICAL EXAMINATION1．在华学习或工作六个月以上的外国人，应按照“外国人体格检查记录”进行体格检查。
The foreigners, who intend to study or work in China for 6 months or more, should go through a physical examination before they come to China according to the requirements of Physical Examination Record for Foreigners.2．外籍人员入境前的健康体检应由所在国公立医院或我使馆认定医院检查，检查结果、健康证明书由当地公证机关或我国使（领）馆证明。
体检表贴照片处，应有医院印章。
健康检查结果应有医院盖章、医师签字、检查日期。
否则，视体检表无效。
The physical examination is supposed be done in a public hospital or a hospital approved by Chinese Embassy. Result of the examination should be notarized by local notarizing authority or certified by Chinese Embassy. The hospital seal is supposed to be put across the photo on the Examination Record. Seal of hospital, signature of physician, and date of examination are required. Otherwise, the record will be viewed as invalid.3．体检项目应包括国际检疫传染病、艾滋病、性病、开放性肺结核病、精神病、麻风病等，血清学检验报告单应包括Anti-HIV, RPR, TPPA, HbsAg, AntiHCV, ALT/GPT等项目，X光检查报告及胸片。
境外人员体格检查记录-u
PHYSICAL EXAMINATION RECORD FOR FOREIGNERS
姓名
Name
性别
Sex
□男Male
□女Female
出生日期
Birth Day-Month-Year
血型
Blood
type
过去是否患有下列疾病：(每项后面请回答“是”或“否”)
Have you ever had any of the following diseases? (Each item must be answered “Yes” or “No”)
毒物瘾Toxicomania …………………………………………………………□No□Yes
精神错乱Mentalconfusion ……………………………………………………□No□Yes
精神病Psychosis:躁狂型Manic psychosis ………………………………□No□Yes
妄想型Paranoid psychosis …………………………□No□Yes
幻觉型Hallucinatory psychosis ……………………□No□Yes
其他精神疾病Other psycho-related illnesses□No□Yes
未发现患有下列检疫传染病和危害公共健康的疾病：
None of the following diseases or disorders found during the present examination
霍乱Cholera性病Venereal Disease
黄热病Yellow fever开放性肺结核Opening lung tuberculosis
鼠疫Plagus爱滋病AIDS
中南林业科技大学外国留学生体格检查记录解读
CentralSouthUniversityof Forestry and Technology
Physical Examination Record for Foreign Students
姓名
Name
性别
Sex
□男Male
□女Female
出生日期Date
of Birth
*精神病Psychosis-------------------------------------------------------------□No□Yes
意见
Suggestion
检查单位盖章
Official Stamp
医师签字
Signature of Physician
日期
Date
*斑疹伤寒Typhus fever ----------------------------------------------------------------□No□Yes
*菌痢Bacillary dysentery ---------------------------------------------------------------□No□Yes
(Each item must be answered “Yes” or “No”)
*读物瘾Toxicomania------------------------------------------------------------------□No□Yes
*精神错乱Mental Confusion---------------------------------------------------------□No□Yes
外国人体格检查记录PhysicalExaminationRecordfor
外国人体格检查记录PHYSICAL EXAMINATION RECORD FOR FOREIGNER体检说明EXPLANATION OF THE PHYSICAL EXAMINATION 1．在华学习或工作六个月以上的外国人，应按照“外国人体格检查记录”进行体格检查。
The foreigners, who intend to study or work in China for 6 months or more, should go through a physical examination before they come to China according to the requirements of Physical Examination Record for Foreigners.2．外籍人员入境前的健康体检应由所在国公立医院或我使馆认定医院检查，检查结果、健康证明书由当地公证机关及我国使（领）馆认证。
体检表贴照片处，应有医院印章。
健康检查结果应有医院盖章、医师签字、检查日期。
否则，视体检表无效。
The physical examination should be done in a public hospital or a hospital recognized by Chinese Embassy. Result of the examination should be notarized by local notarizing authority and certified by Chinese Embassy. The hospital seal is supposed to be put across the photo on the Examination Record. Seal of hospital, signature of physician, and date of examination are required. Otherwise, the record will be viewed as invalid.3．体检项目应包括国际检疫传染病、爱滋病、性病、开放性肺结核病、精神病、麻风病等，血清学检验报告单应包括Anti-HIV, RPR, TPPA, HbsAg, AntiHCV, ALT/GPT等项目，X光检查报告及胸片。
外国人体检表
PHYSICAL EXAMINATION RECORD FOR FOREIGNER
姓名
Name
性别男Male
Sex女Female
出生日期____年___月___日
Date of Birth y.___m.___d.___
照片
Photo
(Put ospital
seal across the photo)
身高/Height(厘米/cm)
体重/Weight(公斤/kg)
血压/Pressure Blood(毫米汞柱/mmHg)
发育情况Development
营养情况Nourishment
颈部Neck
视力
Vision
左L
右R
矫正视力
Corrected
vision
左L
右R
眼Eyes
辨色力/Color sense
(Each item most be answered “Yes” or “No”)
毒物瘾Toxicomania····················································
精神错乱Mental confusion···············································
现在通迅地址
Present mailing adderss
血型
Blood Type
国籍
Natio-
nality出生地B NhomakorabearthPlace
过去是否患有下列疾病：(每项后面请回答“否”或“是”)
Have you ever had any of the following diseases?(Each ietm must be answered “Yes”or “No”
外国人体格检查记录 - STUDY IN CHINA 来华留学联盟
照片photo斑疹伤寒 Typhus fever □No □Yes 菌 痢 Bacillary dysentery □No □Yes现 在 通 信 地 址Present mailing address血型 Blood TypeBlood pressure mmHg 伤寒和付伤寒 Typhoid and paratyphoid fever □No □Yes 流行性脑脊髓膜炎 Epidemic cerebrospinal meningitis □No □Yesorder and security? (Each item must be answered “Yes ”or “No ”)是否患有下列危及公共秩序和安全的病症：（每项后面请回答“否”或“是”）Do you have any ofthe following diseases of disorders endangering the publicAbdomenLymph nodes 扁桃体 Tonsils 腹部 颈部 Neck 眼 Eyes 淋巴结LungsHeart营养情况 Nourishment矫正视力 左 L Corrected vision R 皮肤 Skin 鼻 Nose 肺 Colour sense 耳 Ears 心出 生 地 址Place of BirthWeight kg 发育情况 Development 身高 厘米 Height cm 过去是否患有下列疾病：（每项后面请回答“否”或“是”）(Each item must be answered “Yes ”or “No ”)Have you ever had any of the following diseases? 妄想型 Paranoid psychosis ……………………………□No □Yes 国 籍Nationality体重 公斤 毒 物 瘾 Toxicomania …………………………………………………………… □No □Yes 精神错乱 Mental confusion …………………………………………………… □No □Yes 精 神 病 Pyschosis: 躁狂型 Manic psychosis ………………………………□No □Yes 血压 毫米汞柱出生日期 Date of BirthYr no dayVision R 辨色力幻觉型 Hallucinatory psychosis b ……………………□No □Yes猩 红 热 Scarlet fever □No □Yes 产褥期链球病 Puerperal streptococcus infection 白 喉 Diphtheria □No □Yes 病毒性肝炎 Viral hepatitis □No □Yes 小儿麻痹症 Poliomyelities □No □Yes 布氏杆菌病 Brucellosis □No □Yes视力 左 L 回 归 热 Relapsing fever □No □Yes 感染 □No □Yes 外国人体格检查记录PHYSICL EXAMTNATION RECORD FOR FOREIGNER姓 名Full Name性别Sex□男 Male □女 FemalePDF created with FinePrint pdfFactory trial version 。
外国人体格检查记录
外国人体格检查记录PHYSICAL EXAMINATION RECORD FOR FOREIGNS姓名 Name性别 Sex 男 Male女 Female出生日期 Date of Birth照片 Photo现在通讯地址Present mailing address国籍Nationality出生地址 Birth Place血型 Blood type过去是否患有下列疾病每项后面请回答否或是Have you ever had any of the following diseases? (Each item must be answered "Yes" or "No")斑疹伤寒Typhus fever No Yes 菌痢Bacillary dysentery No Yes 小儿麻痹症Poliomyelitis No Yes 布氏杆菌Brucellosis No Yes 白喉Scarlet fever No Yes 病病毒性肝炎Viral hepatitis No Yes 猩红热Scarlet fever No Yes 产褥期链球菌Puerperal streptococcus infection 回归热Relapsing fever No Yes No Yes 伤寒和副伤寒Typhoid and paratyphoid fever No Yes流行性脑脊髓膜炎Epidemic cerebrospinal meningitis No Yes是否患有下列危及公共秩序和安全的病症每项后面请回答否或是Do you have any of the following diseases or disorders endangering the public order and security?(Each item must be answered "Yes" or "No")毒物瘾Toxicomania---------------------------------------------------------------No Yes 精神错乱Mental confusion-------------------------------------------------------No Yes 精神病Psychosis: 狂躁型Manic Psychosis---------------------------------No Yes 妄想型Paranoid psychosis -----------------------------No Yes 幻觉型Hallucinatory psychosis------------------------No Yes 身高Height cm 体重 Weight 血压Blood pressure 发育情况 Development 营养状况 Nourishment颈部 Nest 视力 左L Vision 右R 矫正视力 左L Corrected vision 右R 眼 Eyes 辨色力Colour sense 皮肤 Skin 淋巴结Lymph nods 耳 Ears 鼻 Nose 扁桃体 Tonsils 心 Heart肺 Lungs腹部Abdomen脊柱Spine 四肢.Extremities神经系统Nervous system其他所见Other abnormal findings胸部X线检查Chest X --rayexam 心电图ECG化验室检查包括血清学诊断Laboratoryexam(Serodiagnosis)未发现患有下列检疫传染病和危害公共健康的疾病None of the following diseases or disorders found during the present examination霍乱Cholera 性病Venereal黄热病Yellow fever 开放性肺结核 Opening lung tuberculosis 鼠疫Plague 爱滋病 AIDS麻风Leprosy 精神病 Psychosis意见检查单位盖章Suggestion Official Stamp医师签字日期Signature of physician Date。
外国人体格检查记录
丙氨酸氨基转移酶ALT(GPT)
血常规Blood Routine
白细胞总数WBC
红细胞总数RBC
血小板总数PLT
血红蛋白HGB
粒细胞百分比NEUT%
淋巴细胞百分比LYM%
尿常规Urine Routine
葡萄糖GLU
蛋白质PRO
红细胞ERY
白细胞LEU
其它Others
血清葡萄糖GLU
心脏
Heart
腹部
Abdomen
脊柱和四肢
Spine&Extremities
神经精神系统
Neuropsychiatric System
泌尿生殖系统
Genitournary System
视力左L
Vision右R
矫正视力左右
Corrected vision L R
辨色力
Color sense
听力左右
Hearing Left Right
眼、耳、鼻、喉
Eyes,Ears,Nose,Throat
心电图
ECG
腹部超声（肝胆脾肾）
Abdomen Ultrasound(Liver,Gallbladder,Spleen,Kidney)
胸部X线
Chest X-ray
艾滋病病毒抗体Anti-HIV
梅毒血清学检测Syphilis Serology
乙型肝炎表面抗原HBsAg
外国人体格检查记录
PHYSICAL EXAMINATION RECORD FOR FOREIGNER
姓名
Name
性别
Sex
□男Male
□女Female
出生日期
Birth DaymonthYear
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外国人体格检查记录
PHYSICAL EXAMINATION RECORD FOR FOREIGNER
体检说明
EXPLANATION OF THE PHYSICAL EXAMINATION 1．在华学习或工作六个月以上的外国人，应按照“外国人体格检查记录”进行体格检查。
The foreigners, who intend to study or work in China for 6 months or more, should go through a physical examination before they come to China according to the requirements of Physical Examination Record for Foreigners.
2．外籍人员入境前的健康体检应由所在国公立医院或我使馆认定医院检查，检查结果、健康证明书由当地公证机关或我国使（领）馆证明。
体检表贴照片处，应有医院印章。
健康检查结果应有医院盖章、医师签字、检查日期。
否则，视体检表无效。
The physical examination is supposed be done in a public hospital or a hospital approved by Chinese Embassy. Result of the examination should be notarized by local notarizing authority or certified by Chinese Embassy. The hospital seal is supposed to be put across the photo on the Examination Record. Seal of hospital, signature of physician, and date of examination are required. Otherwise, the record will be viewed as invalid.
3．体检项目应包括国际检疫传染病、爱滋病、性病、开放性肺结核病、精神病、麻风病等，血清学检验报告单应包括Anti-HIV, RPR, TPPA, HbsAg, AntiHCV, ALT/GPT等项目，X光检查报告及胸片。
体检表应填写清楚。
Examination of International Quarantiable Diseases, AIDS, Venereal Disease, Opening Lung Tuberculosis, Psychosis, Leprosy, etc. must be included. Laboratory Exam Report, X-ray Exam Report and Chest X-ray are supposed to be attached. And Anti-HIV, RPR, TPPA, HbsAg, AntiHCV, ALT/GPT should be shown in the Laboratory Exam Report. All items of this form have to be filled carefully and clearly. 4．到达华中农业大学报到时，体检时间不得超过五个月。
外国人到华中农业大学报到时，我们将体检表及化验室检查报告送至湖北省出入境检验检疫局查验。
凡超期或体检查验不合格者，需在武汉市出入境检验检疫局重新检体，费用自理。
The examination should be done no longer than 5 months ago on the day of registration. After arrival at the University, the Record and laboratory exam certificates will be sent to Bureau of Entry-Exit Inspection and Quarantine of Hubei Province for check. Those whose record is out of date or not valid will be required to do a physical examination in Wuhan. The expenses are supposed to be covered by the examinee.
5．体检表及所有体检报告原件是办理在华居留手续所需文件之一，留学生到达华中农业大学报到时，应提交正本。
建议将表格的第二三页打印在同一页纸的正反面。
Original record and all original examination reports (including X-ray film), which are requisite for residence in China, are required to be submitted on registration at the university. It is suggested to print the second and the third pages of the form on the front and the back of the same piece of
paper.
外国人体格检查记录。