• +91 89036 34060
  • principal@centenaryschool.in

    • Health History Form

      Has your child ever had the following illness? , If so, When??

      Name Yes / No Date
      Chickenpox YesNo
      Measles YesNo
      Diphtheria YesNo
      Malaria YesNo
      Heard Dieases YesNo
      Blood Group YesNo
      Epilepsy YesNo
      Tuberculosis YesNo
      Ear Condition YesNo
      Asthma YesNo
      Allergies YesNo
      Others
      Serious Injury YesNo
      Operation YesNo

      Has your child ever had the following protective measures? , If so, When??

      BCG Vaccination YesNo Polio YesNo Tetanus YesNo Hepatitis A & B YesNo