Dd Form 2808 - Report Of Medical Examination - 2005 Page 2

Download a blank fillable Dd Form 2808 - Report Of Medical Examination - 2005 in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Dd Form 2808 - Report Of Medical Examination - 2005 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

LAST NAME - FIRST NAME - MIDDLE NAME (SUFFIX)
SOCIAL SECURITY NUMBER
LABORATORY FINDINGS
45. URINALYSIS
46. URINE HCG
47. H/H
48. BLOOD TYPE
a. Albumin
b. Sugar
TESTS
HIV SPECIMEN ID LABEL
DRUG TEST SPECIMEN ID LABEL
RESULTS
49. HIV
50. DRUGS
51. ALCOHOL
52. OTHER
a. PAP SMEAR
b.
c.
MEASUREMENTS AND OTHER FINDINGS
53. HEIGHT
54. WEIGHT
55. MIN WGT - MAX WGT
MAX BF %
56. TEMPERATURE
57. PULSE
lbs.
59. RED/GREEN (Army Only)
60. OTHER VISION TEST
58. BLOOD PRESSURE
a. 1ST
b. 2ND
c. 3RD
SYS.
SYS.
SYS.
DIAS.
DIAS.
DIAS.
61. DISTANT VISION
62. REFRACTION BY AUTOREFRACTION OR MANIFEST
63. NEAR VISION
Right 20/
Corr. to 20/
By
S.
CX
Right 20/
Corr. to 20/
by
Left 20/
Corr. to 20/
By
S.
CX
Left 20/
Corr. to 20/
by
64. HETEROPHORIA (Specify distance)
Prism Conv
ES
EX
R.H.
L.H.
Prism div.
NPR
PD
CT
65. ACCOMMODATION
66. COLOR VISION (Test used and result)
67. DEPTH PERCEPTION (Test used and score) AFVT
Right
Left
PIP
/14
Uncorrected
Corrected
68. FIELD OF VISION
69. NIGHT VISION (Test used and score)
70. INTRAOCULAR TENSION
O.D.
O.S.
72a. READING ALOUD
71a. AUDIOMETER
Unit Serial Number
71b. Unit Serial Number
TEST
Date Calibrated (YYYYMMDD)
Date Calibrated (YYYYMMDD)
500
1000
2000
3000
4000
6000
500
1000
2000
3000
4000
6000
SAT
UNSAT
HZ
HZ
Right
Right
72b. VALSALVA
SAT
UNSAT
Left
Left
73. NOTES (Continued) AND SIGNIFICANT OR INTERVAL HISTORY (Use additional sheets if necessary.)
DD FORM 2808, OCT 2005
Page 2 of 3 Pages

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Dd Form 2697 - Report Of Medical Assessment Dd Form 2697 - Report Of Medical Assessment Business
Dd Form 882 - Report Of Inventions And Subcontracts - 2005 Dd Form 882 - Report Of Inventions And Subcontracts - 2005 Business
Dd Form 882 - Report Of Inventions And Subcontracts - 2005 Dd Form 882 - Report Of Inventions And Subcontracts - 2005 Business
Form Dma 5006 - Report Of Medical Examination North Carolina Department Of Human Resources Form Dma 5006 - Report Of Medical Examination North Carolina Department Of Human Resources Legal
Form I-693 Report Of Medical Examination And Vaccination Record Form I-693 Report Of Medical Examination And Vaccination Record Legal
Form I-693 - Report Of Medical Examination And Vaccination Record Form I-693 - Report Of Medical Examination And Vaccination Record Legal
Form I-693 - Report Of Medical Examination And Vaccination Record Form I-693 - Report Of Medical Examination And Vaccination Record Legal
Form I-693 - Report Of Medical Examination And Vaccination Record Form I-693 - Report Of Medical Examination And Vaccination Record Legal
Dd Form 261, Report Of Investigation Line Of Duty And Misconduct Status Dd Form 261, Report Of Investigation Line Of Duty And Misconduct Status Business
Dd Form 261 - Report Of Investigation - Line Of Duty And Misconduct Status Dd Form 261 - Report Of Investigation - Line Of Duty And Misconduct Status Business

Related Categories

Parent category: Business
Download
Go
Page of 3