HI - PRECISION DIAGNOSTICS

1852 Taft Avenue, Malate Manila

Tel. No. 405-0039 / 405-0135

MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
CONCENTRIX-CVG 3/7/2023 8:59:50AM
PATIENT NAME BIRTHDATE
SALANGSANG, EDMAR SERAFICA 04/22/1992

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.

SALANGSANG, EDMAR SERAFICA

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.
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).

Classification is Pending due to:

1. Needs additional tests: chest x-ray apicolordotic view

Physician: ANNE DOMINIQUE ESGUERRA - BORGONOS, M.D.

License #: 130442
** Report Electronically Signed Out ** Date: 3/8/2023 8:26:57AM

SALANGSANG, EDMAR SERAFICA - MB013514

2324011543 Page 1 of 3
 HI - PRECISION DIAGNOSTICS
1852 Taft Avenue, Malate Manila
Tel. No. 405-0039 / 405-0135

MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
CONCENTRIX-CVG 3/7/2023 8:59:50AM
PATIENT NAME BIRTHDATE
SALANGSANG, EDMAR SERAFICA 04/22/1992
SEX AGE CIVIL STATUS TEL NO OCCUPATION
M 30 Single 0 CALL CENTER AGENT
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. 1 sticks/day for 2 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. 2 ( X ) bottle(s) ( ) glass ( ) shot(s) / session
14. Kidney or Bladder Condition [ ] [ X ] 31 b. ( X ) Occasional ( ) Frequent
15. Female Reproductive System Condition [ ] [ X ] 32. Last Menstrual Period:
16. Male Reproductive System Condition [ ] [ X ] 32 a. ( ) 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
160.0cm 54.2kg 130/80 mmHg 89/min 20/min 21.2 kg/m 2 Normal
43. Visual Acuity Far Vision Near Vision
Uncorrected OD 20 / 40 OS 20 / 70
Corrected ( ) with eyeglasses ( ) with contact lenses
Normal MEDICAL HISTORY AND PHYSICAL EXAM REMARKS
Yes No 2. Error of refraction
33. DIANE PILL
44. Skin X
44. Tattoo: BOTH WRIST ; Congenital marks: L UPPER CHEST; Nevus: MENTUM
45. Head, Scalp X 47. Ear Piercing: AU
46. Eyes X 49. Dental pathologies (caries, plaques, root fragments, etc)
47. Ears X 51. Engorged: ON DIANE PILL X 5 YRS (2018 - PRESENT)
56. Refused
48. Nose, Sinuses X 57. Refused
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: AIMA KRISHA B. BUENCONSEJO, MD PRC License #: 0150397
SALANGSANG, EDMAR SERAFICA - MB013514
2324011543 Page 2 of 3
 HI - PRECISION DIAGNOSTICS
1852 Taft Avenue, Malate Manila
Tel. No. 405-0039 / 405-0135

MEDICAL REPORT
COMPANY NAME DATE OF EXAMINATION
CONCENTRIX-CVG 3/7/2023 8:59:50AM
PATIENT NAME BIRTHDATE
SALANGSANG, EDMAR SERAFICA 04/22/1992
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.

140/90 > 130/80

TEST SUMMARY
Test Findings Recommendations

MEDICAL THE FOLLOWING ITEMS WERE NOTED WHILE REFER TO VISION AND EYE SECTION OF
HISTORY TAKING THE PATIENT MEDICAL HISTORY: THE PHYSICAL EXAM.
EYE PROBLEMS: ERROR OF REFRACTION

PE DURING PHYSICAL EXAMINATION THE FOLLOWING SUGGEST REGULAR OPTOMETRIST VISIT.

ITEMS WERE OBSERVED:
ERROR OF REFRACTION IN DISTANCE VISION.

MOUTH: DENTAL CARIES / ROOT FRAGMENTS SUGGEST DENTAL CONSULTATION.

DRUG TEST NEGATIVE

X-RAY SUSPICIOUS OPACITIES ARE SEEN IN THE BOTH FOR CHEST X-RAY APICOLORDOTIC VIEW.
UPPER LUNG FIELDS, PARTIALLY PROJECTED
ONTO THE OSSEOUS STRUCTURES.

Evaluation Date Remarks Classification Evaluator

3/8/2023 8:26AM Classification is Pending due to: PENDING ANNE DOMINIQUE

ESGUERRA -
1. Needs additional tests: chest x-ray apicolordotic view BORGONOS, M.D.,
License No.: 130442

ADDITIONAL EVALUATION REMARKS

SALANGSANG, EDMAR SERAFICA - MB013514

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