China Mobile (Hong Kong) Limited Annual Report 2003SUPPLEMENTARY INFORMATION FOR ADS HOLDERSThe Group’s accounting policies conform with generally accepted accounting principles in Hong Kong (“HK GAAP”)which differ in certain material respects from those applicable generally accepted accounting principles in theUnited States of America (“US GAAP”). The significant differences relate
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Patient Name: ___________________________________________ Date Of Birth: ___________________ CIRCLE APPROPRIATE ANSWER (Leave blank if you do not understand the question)
If NO, explain:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Yes No Has there been a change in your health within the last year? If YES, explain:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Yes No Are you being treated by a physician now? If YES, explain:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Name of physician _______________________________________________________________________Date of last medical examination ____________________________________________________________ HAVE YOU HAD OR DO YOU HAVE ANY OF THE FOLLOWING? (Please Check)
Describe any surgeries you have had.
__________________________________________________________________________________________________________________________________________________________________________ Yes No Have you been diagnosed with sleep apnea?Yes No Do you have a CPAP machine? Yes No If you do have a CPAP machine, are you comfortable with it? ARE YOU ALLERGIC TO OR HAVE YOU HAD A REACTION TO ANY OF THE FOLLOWING? (Please Check)
Other Allergies__________________________________________________________________________________________________________________________________________________________________________ MEDICATIONS AND PRESCRIPTIONS
Please list supplements, prescription or recreational drugs you are taking__________________________________________________________________________________________________________________________________________________________________________ ARE YOU TAKING OR HAVE YOU TAKEN ANY OF THE FOLLOWING IN THE LAST 3 MONTHS? (Please Check)
Yes No Do you have or have you had any other diseases or medical problems NOT listed on this form? If YES, explain:__________________________________________________________________________________________________________________________________________________________________________ Yes No Have you ever been pre-medicated for dental treatment? If YES, explain:__________________________________________________________________________________________________________________________________________________________________________ If YES, explain:__________________________________________________________________________________________________________________________________________________________________________ WOMEN ONLY
Yes No Are you taking birth control pills? The practice of dentistry involves treating the whole person. If the dentist determines that there may be a potential medically- compromised situation, medical consultation may be needed prior to commencement of dental treatment. I authorize the dentist to contact my physician. I have read and understand this form. To the best of my knowledge, I have answered every question completely and accurately. I will inform my dentist of any change in my health and/or medication. I will not hold my dentist, or any other member of his/her staff, responsible for any errors or omissions that I may have made in the completion of this form.
Signature of Patient (Write Adult name here) _________________________________ Date _______________
LEGAL ENFORCEMENT OF SOCIAL RIGHTS: ENABLING CONDITIONS AND IMPACT ASSESSMENT Abstract This article commends the concise and useful analysis of courts and the legal enforcement of economic, social and cultural rights given in Christian Courtis’s book, Courts and the Legal Enforcement of Economic, Social and Cultural Rights: Comparative Experiences of Justiciability . Yet, in order to com