How to Fill Out a Medical Form in Japan
Filling out documents in a language you are not familiar with is stressful. Especially filling out a medical form when you’re in dire need of medical attention.
Whether you got sick or hurt yourself while traveling to Japan, or you have just started living in Japan and know little Japanese, this guide will help you in filling out a medical form in Japan.
In this article, you will come to know how to fill out a medical form and be able to understand Japanese medical terms.
When you arrive at the hospital or clinic, you will be handed a medical form consisting of questions regarding your condition.
問診票 (Monshin hyou) or “Medical Questionnaire” is a medical form that you need to fill out including your basic information, symptoms you‘re having, and medical history.
The following is an example of a typical Medical Form in Japan.
If you can’t read Japanese characters, don’t fret. The following is a handy list of vocabularies in Japanese with their corresponding English translation.
Basic Information Vocabulary
Date of Birth
If you’re not familiar with Taisho, Showa, and Heisei, these are eras in Japan. If you were born between July 30, 1912 and Dec 25, 1926, then you need to encircle the word Taisho.
Those who were born between December 25, 1926 and January 7, 1989, will have to encircle the word Showa.
And for those born between January 8, 1989 and April 30, 2019, the word Heisei should be encircled.
Common colds symptoms
Runny nose / nasal congestion
Cough / phlegm
Joints (knee, elbow, etc.) hurting
Others (please specify)
Shortness of breath
Feeling of pressure in chest
Loss of appetite
Back (of body)
Lipid metabolism disorder
Eczema / rash
Encircle the corresponding symptoms and body parts that are aching.
Medical History Vocabulary
Name of hospital
Lung and Bronchial Disease
Legs and Joints Disease
If you have a history or have experienced in the past any of the diseases mentioned, draw a circle around the corresponding word.
And that’s pretty much it. All you have to do next is to submit your medical form and get checked. Get well soon. Take care.
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