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O stglorycollege.ac.tz Website: www.stglorychas.ac.tz MEDICAL EXAMINATION REPORT NAME: CLASS: Please bring this Form when dully filled in accordance to the request, it should therefore be filled by Medical Officer, Assistant medical officer or Senior Clinical Officer. No. The medical examination will be done at school after the first installment. Organ/system 01. Respiratory 04. Skin 05. Cardiovascular 06. Central N. S.

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