With the question form for health state check and combination of check seal and reply form

摘要

Topic From correlation of the check result due to medical examination data check entry and life habit check entry presently of the medical examinee and even in the general people try future health state to be able to grasp easily at the glance.SolutionsIt consisted of with the question form and the check seal and the reply form 20 which it makes multiple medical examination data check entries and life habit check entry correspond, the check seal every check entry level number were divided had the medical examination data check seal and the life habit check seal which in multiple degree of healthy level numbers, in medical examination data check result reply indicatory department 22 of the reply form, tried the medical examination data check seal to stick the life habit check seal in life habit check result reply indicatory department 25 of the reply form. In addition, the reply form was formed with to healthy check result reply indicatory field 21A and unhealthy check result reply indicatory field 21B separately. Choice figure Drawing 1