M Comprehensive health screening of prisoner at the time of admission to prison 100. What all should be part of health screening of the prisoner at the time of admission in the jail? The following information should be recorded about the health condition of the prisoner upon admission in jail. Proforma for health screening of prisoner upon admission to Prison Case No............. Name ................................. Age ...................years Father's/Husband's Name............................................................. Sex: Male/Female/Other Occupation ........................................................................................... Date & Time of admission in the prison…….............................. Identi ication mark:................................................................................................................ Consent for examination &Investigations:(signature)…….........................……….. Thumb impression.................................................................................................................. Date and time of medical examination: Examined by Doctor: Sign & name in capital letters. If any communication/language barrier between doctor and prisoner: Chief complaints (if any): Previous History of illness Past H/O TB/DM/HT/Psychiatric illness: Past h/o any surgical operation: Are you suffering from any disease? Yes/No If so, the name of the disease: Are you now taking medicines for the same? Are you suffering from cough that has lasted for Yes/No (2 weeks or more) History of drug abuse, if any/Craving for any drug Any information the prisoner may volunteer: MEDICAL DIMENSION OF FREQUENTLY ENCOUNTERED CASES | 70

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