Questions 1-5
Complete the form below.
Write NO MORE THAN ONE WORD OR A NUMBER for each answer.
Oakham Surgery New Patient Form
Example NEW PATIENT’S ROAD | Answer Dawson Road |
FULL NAME | Mike 1 |
WIFE’S FIRST NAME | Janet |
CHILDRENS’ FIRST NAMES | 1st 2 2nd 3rd 4th |
ADDRESS | 52 Dawson Road 3 Melbourne |
HEALTH CARD NUMBER | 4 |
WIFE’S HEALTH CARD NUMBER | will give later |
PREFERRED DOCTOR SELECTED | 5 White |
Questions 6-10
Circle the correct letters A, B, or C.
6 When is Mike’s wife’s first appointment?
7 What is the surgery’s phone number?
8 What is the name of the girl with whom Mike is speaking at the surgery?
9 What’s the night doctor’s mobile number?
10 Which of the following does the surgery NOT make a charge for?
31 The Pacific is more prone to tsunami because…
32 The biggest tsunami are usually created by…
33 Tsunami are difficult to detect in deep water because of…
Questions 36-40
Questions 36-40
Write NO MORE THAN THREE WORDS for each answer.
When Happened | Cause | Deaths Caused | Wave Height |
1992 | 36 | none | 3 feet |
1992 | Underwater earthquake | none | 37 |
1998 | 38 | 1200 | 23 feet |
1998 | Underwater volcanic eruption | 3000 | 40 feet |
1896 | Underwater earthquake | 39 | 35 feet |
8000 years ago | Underwater landslide | 40 | 30 feet |