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의사 발급 건강 진단서
(Certificate of Health)
This certificate will be highly appreciated in the process of selection of Korean Government Scholarship recipients and the admissions to a Korean university. Please attach evidential documents which prove that the result of the following examinations is true and correct; otherwise, it is not valid.
1. Personal Information
Date of Birth:
Blood Pressure: Systolic Diastolic mmHg
Vision: Right 20/ Left 20/ Color Vision
Corrected: Right /15 Left /15
Dental Evaluation: Good ( ) Fair ( ) Poor ( ) Needs Attention ( )
Urine: S.G. Sugar Micro
Stool for Parasite Oval:
Serological Test for Syphilis:
In my opinion his/her health condition is;
Excellent ( ) Good ( ) Fair ( ) Poor ( )
This is to certify that the above named applicant has gone through a general medical examination and the findings indicated here are true and correct to the best of my knowledge.
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