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Get Medical Examiner's Confidential Report LIC03-01

DENTIAL REPORT No./Page No. Full Name of the Life to be examined Case No. Month Year Age: Sex: Identification marks: 3. Introducer’s name & designation 4. Height (cms) : Weight (kgs): Chest (cms) (over nipple): Full Expiration (cms): 1. Pulse Rate p.m. Blood Pressure 1st reading 2nd reading Introducer’s signature: Girth of abdomen (cms) (over navel) Full inspiration (cms): Systolic Diastolic If answer/s to any of the following questions is ‘Yes’, please give full details an.

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