HI-PRECISION DIAGNOSTICS
San Jose del Monte City, Bulacan, Philippines
Contact Nos.: (63) 917-847-1522 / (63) 920-977-3474
MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
REFERRAL 4/10/2023 10:30:12AM
PATIENT NAME BIRTHDATE
CASERO, MARICRIS FLORES 08/07/1994
I hereby certify that all the information I have disclosed, as reflected in this report, are true to the best of my knowledge and
belief, and that any misrepresentation or concealment on my part may lead to consequences, which may or may not include
termination, legal prosecution, expulsion, disqualification, etc.
I hereby authorize Hi-Precision Diagnostics and its officially designated examining physicians and staff to conduct the
examinations necessary to assess my fitness to work.
I give my consent to this clinic and its officially designated examining physicians and staff to furnish the results of this
examination to my potential employers or their authorized representatives
By signing this, I hold Hi-Precision Diagnostics and it’s authorized physicians and staff free from any criminal, civil,
administrative, ethical, and moral liability, that may arise from the above.
CASERO, MARICRIS FLORES
Printed name and Signature of Patient
MEDICAL EXAMINATION RATING SYSTEM
(Occupational Safety and Health Standards)
Department of Labor and Employment
RECOMMENDATION:
Class A - Physically fit for any work.
ü Class B - Physically under-developed or with correctible defects, (error of refraction dental caries,defective hearing, and
other similar defects) but otherwise fit to work.
Class C - Employable but owing to certain impairments or conditions, (heart disease, hypertension, anatomical defects )
requires special placement or limited duty in a specified or selected assignment requiring follow -up treatment/periodic
evaluation.
Class D - Unfit or unsafe for any type of employment (active PTB, advanced heart disease with threatened failure,
malignant hypertension, and other similar illnesses).
Physician: ANNA LYN N. CHUA, MD
License #: 0127217
** Report Electronically Signed Out ** Date: 4/12/2023 1:21:43PM
CASERO, MARICRIS FLORES - SJ019792
2371010773 Page 1 of 4
HI-PRECISION DIAGNOSTICS
San Jose del Monte City, Bulacan, Philippines
Contact Nos.: (63) 917-847-1522 / (63) 920-977-3474
MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
REFERRAL 4/10/2023 10:30:12AM
PATIENT NAME BIRTHDATE
CASERO, MARICRIS FLORES 08/07/1994
SEX AGE CIVIL STATUS TEL NO OCCUPATION
F 28 Married 0 HR staff
MEDICAL HISTORY (For any Yes answers, please see Remarks)
Yes No Yes No
1. Head or Neck Injury Condition [ ] [ X ] 22. Hepatitis [ ] [ X ]
2. Eye Disease [ ] [ X ] 23. Tuberculosis [ ] [ X ]
3. Ear Disease or Deafness [ ] [ X ] 24. Malaria [ ] [ X ]
4. Nose or Throat Disease [ ] [ X ] 25. Dengue [ ] [ X ]
5. Skin / Scalp / Nail / Hair Condition [ ] [ X ] 26. Typhoid [ ] [ X ]
6. Asthma or Other Lung Disease [ ] [ X ] 27. Other Tropical / Parasitic Diseases [ ] [ X ]
7. Diabetes Mellitus [ ] [ X ] 28. Cancer / Tumor / Blood Dyscrasia [ ] [ X ]
[ ] [ X ] 29. Hospitalization / Operations [ ] [ X ]
8. Thyroid Disease
[ X ] 30. Smoker - Cigarette [ ] [ X ]
9. Other Endocrine Disease [ ]
30 a. sticks/day for years.
10. High Blood Pressure [ ] [ X ]
11. Heart Disease [ ] [ X ] 30 b. Quit smoking since
12. Digestive System Condition [ ] [ X ] 31. Alcoholic Beverage Drinker [ ] [ X ]
13. Hernia [ ] [ X ] 31 a. ( ) bottle(s) ( ) glasses ( ) shot(s) / session
14. Kidney or Bladder Condition [ ] [ X ] 31 b. ( ) Occasional ( ) Frequent
15. Female Reproductive System Condition [ ] [ X ] 32. Last Menstrual Period: 3/29/2023 to 4/2/2023 G. 1 P. 1 (1-0-0-1)
16. Male Reproductive System Condition [ ] [ X ] 32 a. ( X ) Reg ( ) Irreg ( ) Menopausal ( ) Surg. Menopause
17. Sexually Transmitted Disease [ ] [ X ] 32 b. ( ) Pregnant ( ) Post Partum ( ) No Menarche
18. Musculoskeletal Condition [ ] [ X ] 33. Present Medications [ ] [ X ]
19. Frequent Headaches / Dizziness [ ] [ X ] 34. Congenital Disease / Deformity [ ] [ X ]
20. Psychiatric Condition [ ] [ X ] 35. Allergies [ ] [ X ]
21. Seizures, Other Neurologic Disorders [ ] [ X ] 36. Family Medical History [ ] [ X ]
PHYSICAL EXAMINATION
37. HEIGHT 38. WEIGHT 39. BLD. PRESSURE 40. PULSE 41. RESPIRATION 42. BMI
149.0cm 53.0kg 130/80 mmHg 88/min 15/min 23.9 kg/m 2 Normal
43. Visual Acuity Far Vision Near Vision
Uncorrected
Corrected ( X ) with eyeglasses ( ) with contact lenses OD 20 / 32 OS 20 / 25
Normal MEDICAL HISTORY AND PHYSICAL EXAM REMARKS
Yes No
46. Others: dx: 2019 pinguecula -OU
44. Skin X
49. Missing teeth; Dental appliances (dentures, braces, splints, etc): denture-upper
45. Head, Scalp X 51. Refused
46. Eyes X 56. Refused
47. Ears X 57. Refused
48. Nose, Sinuses X
49. Mouth, Throat X
50. Thyroid, Neck X
51. Breast - Axilla X
52. Lungs X
53. Heart X
54. Abdomen X
55. Back X
56. Anus-rectum X
57. G-U System, X
Inguinal
58. Extremities X
Examining Physician: ANNA LYN N. CHUA, MD PRC License #: 0127217
CASERO, MARICRIS FLORES - SJ019792
2371010773 Page 2 of 4
HI-PRECISION DIAGNOSTICS
San Jose del Monte City, Bulacan, Philippines
Contact Nos.: (63) 917-847-1522 / (63) 920-977-3474
MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
REFERRAL 4/10/2023 10:30:12AM
PATIENT NAME BIRTHDATE
CASERO, MARICRIS FLORES 08/07/1994
ADDITIONAL MEDICAL HISTORY AND PHYSICAL EXAMINATION REMARKS
PATIENT DECLARES THAT HE/SHE HAS NO COVID-RELATED SYMPTOMS FOR THE PAST 10 DAYS, AND NO
EXPOSURE TO KNOWN COVID PATIENTS NOR RECENT TRAVEL OUT OF THE COUNTRY FOR THE PAST 14 DAYS.
PATIENT HAS UNDERGONE COVID-19 VACCINATION.
1ST DOSE: SINOVAC
2ND DOSE: SINOVAC
PX HAS IMPLANT (CONTRACEPTION) LEFT ARM
TEST SUMMARY
Test Findings Recommendations
MEDICAL UNREMARKABLE
HISTORY
PE BP: 130/80 MMHG ADVISED FOR LOW SALT LOW FAT
DIET,DAILY BP MONITORING,ADVISED TO
SEEK CONSULT ONCE WITH ELEVATED BP
ERROR OF REFRACTION FOR DAILY USE AND REGULAR UPDATING
OF EYEGLASSES
EYES: OTHERS: DX: 2019 PINGUECULA -OU ADVISED TO HAVE A FOLLOW UP CHECK UP
TO HER OPHTHALMOLOGIST
MOUTH, THROAT: MISSING TEETH; DENTAL ADVISED FOR REGULAR DENTAL CHECK UP
APPLIANCES (DENTURES, BRACES, SPLINTS, ETC):
DENTURE-UPPER
HEMATOLOGY NORMAL
FECALYSIS NORMAL
URINALYSIS NORMAL
DRUG TEST NEGATIVE
X-RAY PENDING - AWAITING RESULT FOR RE-EVALUATION ONCE WITH RESULT
IMMUNOLOGY REFER TO ADDITIONAL EVALUATION REMARKS
CASERO, MARICRIS FLORES - SJ019792
2371010773 Page 3 of 4
HI-PRECISION DIAGNOSTICS
San Jose del Monte City, Bulacan, Philippines
Contact Nos.: (63) 917-847-1522 / (63) 920-977-3474
MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
REFERRAL 4/10/2023 10:30:12AM
PATIENT NAME BIRTHDATE
CASERO, MARICRIS FLORES 08/07/1994
Evaluation Date Remarks Classification Evaluator
4/11/2023 1:21PM Classification is Pending due to: PENDING ANNA LYN N. CHUA,
MD, License No.:
1. Specimen/Image received but still awaiting official results 0127217
of the following tests: CHEST XRAY
4/12/2023 1:21PM CHEST XRAY: NORMAL CLASS B ANNA LYN N. CHUA,
MD, License No.:
0127217
ADDITIONAL EVALUATION REMARKS
IMMUNOLOGY
ANTI-HAV IGM (CMIA) 0.10 NONREACTIVE
CASERO, MARICRIS FLORES - SJ019792
2371010773 Page 4 of 4
