Page 10 - Hauna Handbook 2022
P. 10

Name :  ............................................................................................  Grade : .........................Sec: ..................
       Father / Guardian’s Name :...................................................... Mother’s Name :.............................................

       Emergency phone number (to reach parents): ................................................................................................

       Physician to be called in emergency:................................................................................................................
       Address: .........................................................................................................................................................

       Telephone No.............................................................................Mobile No: ...................................................
       Neighbour, friend or relative to be called in emergency or illness:

       Address:..........................................................................................................................................................

       ........................................................................................................................................................................
       Telephone No :............................................... Mobile No.:..............................................................................

       Has the child ever suffered from the following? If so, when?
       Asthma/Allergies/Diabetes/Epilepsy/Heart/Disease/Ophthalmic/Defect/Auditory defect/hearing loss

       ........................................................................................................................................................................

       Is the child on any medication?  Yes/No.   If yes, please give details

       ........................................................................................................................................................................
       Blood group of the child:...........................

       Does your child wear glasses? Yes/No.
       Does your child wear them at all times or only for classwork?...........................................

       Is there anything concerning the health of your child which the school should know in order to provide special care?
       (Include things such as allergies to insects, food or medicine)

       ........................................................................................................................................................................
















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