Head and Neck 头和颈部 Mouth and throat 口腔和喉部 Ears 耳 nose 鼻 Eyes including fundi 眼睛包括眼底 Heart 心脏 Chest, lungs and breast 胸，肺和乳房 Abdomen, liver, spleen,etc. 腹部，肚，脾等 Genito-urinary system 泌尿生殖系统 Hernial sites 疝气 Extremities and spine 脊柱和四肢 Nervous system 神经系统 Skin including surgical scars 皮肤包括手术疤痕 Lymphatic system 淋巴系统 Evidence of mental abnormality 精神病症状 Any other abnormalities 其他不正常情况 Female applicant pregnant if yes, date of L.M.P. 女申请者是否怀孕？如是 ，注明最后月经日期 Is the appllicant now taking medication or receiveing treatment of any kind? If so, specify 申请人目前是否服用药物或接受其他治疗？如是，请说明 Height 身高 Weight 体重 Visual acuity with glasses if worn 视力(如近视则测矫正视力) Hearing whispered voice(normal: 6 meters(20 feet)) 听力 Blood presure 血压 If abnormal repeat B.P. after resting 如果不正常，稍后再量 Pulse rate 脉搏 Pulse rhythm 脉搏节率 Mental development 智力发育(正常与否) Please elaborate on all "yes" answers or abnormalities 请对回答是“是”的问题加以详细说明 Routine blood serologial tests for syphils (Candidates 15 years of age and older) 梅毒常规血清试验(15岁以下申请人免检) FTA-ABS.(only in VDRL positive) Urinalysis (Candidates 5 years of ages and older) 尿检(5岁以下免检) Protein 蛋白 Sugar 糖 Microscopic 显微镜检验结果 If abnormal, repeat. Large postero anterior chest X-ray film and report (required for all a pplicants 11 years of ages and older) 所有11岁以上人士必须进行X光检查。
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