EXAMEN FISICO INTEGRAL

FECHA___________
Pre empleo__ Post empleo__ Pre vacacional__ Post vacacional ________
Empresa: _____________________________________________________________________
Nombre: ______________________________________________________________________
Edad: ________________________________________________________________________
Labor que desempeña___________________________________________________________
Antecedentes .incluir trabajos anteriores____________________________________________
Cabeza: ______________________________________________________________________
Ojo: _________________________________________________________________________
O.R.L oído, nariz, garganta: _______________________________________________________
Cuello: _______________________________________________________________________
Miembros superiores: ___________________________________________________________
Piel: _________________________________________________________________________
Tórax: ________________________________________________________________________
Corazón: ______________________________________________________________________

Tensión Arterial ________________________________________________________________

Pulso: ________________________________________________________________________
Pulmones: ____________________________________________________________________
Columna: _____________________________________________________________________
Abdomen incluir hernias: _________________________________________________________
Genitales incluir hernias: _________________________________________________________
Miembros inferiores: ____________________________________________________________
Reflejos: ______________________________________________________________________
Peso: ________________________________________________________________________
Laboratorio: ___________________________________________________________________
Rx tórax: ______________________________________________________________________
ECG: _________________________________________________________________________
Impresión diagnostica: __________________________________________________________
Observaciones: ________________________________________________________________
Recomendaciones: _____________________________________________________________