Olayın Gerçekleştiği Tarih | Peronel T.C. | Personel Adı-Soyadı | Olay Anı Kan Sonucu | 1. Ay Kan Sonucu | 3.Ay Kan Sonucu | 6.Ay Kan Sonucu | Biliniyorsa Hastanın Sonucu | Yapılan Uygulamalar/eğitimler | Personel İmzası |
Tarih: | Tarih: | Tarih: | Biliniyorsa Hastanın Sonucu | ||||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
||||
…./…./...….. | anti-Hbs: Anti-HCV: HbsAG: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |
anti-Hbs: HbsAG: Anti-HCV: Anti-HIV: |