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AH.YD.001 - AMELİYATHANE KAYIT DEFTERİ

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Doküman Kodu: AH.YD.001

Yayın Tarihi: 15.11.2011

Revizyon Tarihi: 15.04.2022

Revizyon No: 4

Sayfa: Otomatik

Sıra No	Hastanın Adı: TC:	Ameliyatın Adı:	Hastalığın Tanısı:	Operatör:	Asistan:	Ameliyatın Evresi: Sonuç:
Hasta Kabul No:	Soyadı:	Tarihi:	Anatoma Patolojik Tanı:	Operatör:	Asistan:
		Kodu:		Hemşire:	Anestezist:
Bölüm Kayıt No:	Doğum Yeri, Yılı	Sınıflama [] Büyük [] Orta [] Küçük	Anestezi Şekli:	Hemşire:	Anestezist:
Sıra No	Hastanın Adı: TC:	Ameliyatın Adı:	Hastalığın Tanısı:	Operatör:	Asistan:	Ameliyatın Evresi: Sonuç:
Hasta Kabul No:	Soyadı:	Tarihi:	Anatoma Patolojik Tanı:	Operatör:	Asistan:
		Kodu:		Hemşire:	Anestezist:
Bölüm Kayıt No:	Doğum Yeri, Yılı	Sınıflama [] Büyük [] Orta [] Küçük	Anestezi Şekli:	Hemşire:	Anestezist:
Sıra No	Hastanın Adı: TC:	Ameliyatın Adı:	Hastalığın Tanısı:	Operatör:	Asistan:	Ameliyatın Evresi: Sonuç:
Hasta Kabul No:	Soyadı:	Tarihi:	Anatoma Patolojik Tanı:	Operatör:	Asistan:
		Kodu:		Hemşire:	Anestezist:
Bölüm Kayıt No:	Doğum Yeri, Yılı	Sınıflama [] Büyük [] Orta [] Küçük	Anestezi Şekli:	Hemşire:	Anestezist:
Sıra No	Hastanın Adı: TC:	Ameliyatın Adı:	Hastalığın Tanısı:	Operatör:	Asistan:	Ameliyatın Evresi: Sonuç:
Hasta Kabul No:	Soyadı:	Tarihi:	Anatoma Patolojik Tanı:	Operatör:	Asistan:
		Kodu:		Hemşire:	Anestezist:
Bölüm Kayıt No:	Doğum Yeri, Yılı	Sınıflama [] Büyük [] Orta [] Küçük	Anestezi Şekli:	Hemşire:	Anestezist:
Sıra No	Hastanın Adı: TC:	Ameliyatın Adı:	Hastalığın Tanısı:	Operatör:	Asistan:	Ameliyatın Evresi: Sonuç:
Hasta Kabul No:	Soyadı:	Tarihi:	Anatoma Patolojik Tanı:	Operatör:	Asistan:
		Kodu:		Hemşire:	Anestezist:
Bölüm Kayıt No:	Doğum Yeri, Yılı	Sınıflama [] Büyük [] Orta [] Küçük	Anestezi Şekli:	Hemşire:	Anestezist:

<table style="border-collapse:collapse" class=" cke_show_border" cellspacing="0"><tbody><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:3px double black; height:53px; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Sıra No</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:3px double black; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Hastanın Adı:<br><br>TC:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:3px double black; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Ameliyatın Adı:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:3px double black; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Hastalığın Tanısı:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:3px double black; text-align:left; vertical-align:top; width:78px"><span style="font-size:15px"><span style="color:black">Operatör:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:3px double black; text-align:left; vertical-align:top; width:87px"><span style="font-size:15px"><span style="color:black">Asistan:</span></span></td><td rowspan="4" style="border-bottom:3px double black; border-left:1px solid black; border-right:3px double black; border-top:3px double black; text-align:left; vertical-align:top; width:313px"><span style="font-size:15px"><span style="color:black">Ameliyatın Evresi:<br><br><br><br><br><br><br>Sonuç:</span></span></td></tr><tr><td style="border-bottom:none; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hasta Kabul No:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black">Soyadı:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Tarihi:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Anatoma Patolojik Tanı:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Kodu:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hemşire:</span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezist:</span></span></td></tr><tr><td style="border-bottom:3px double black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Bölüm Kayıt No:</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Doğum Yeri, Yılı</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Sınıflama<br>[] Büyük<br>[] Orta<br>[] Küçük</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezi Şekli:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Sıra No</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Hastanın Adı:<br><br>TC:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Ameliyatın Adı:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hastalığın Tanısı:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Operatör:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Asistan:</span></span></td><td rowspan="4" style="border-bottom:3px double black; border-left:1px solid black; border-right:3px double black; border-top:none; text-align:left; vertical-align:top; width:313px"><span style="font-size:15px"><span style="color:black">Ameliyatın Evresi:<br><br><br><br><br><br><br>Sonuç:</span></span></td></tr><tr><td style="border-bottom:none; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hasta Kabul No:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black">Soyadı:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Tarihi:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Anatoma Patolojik Tanı:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Kodu:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hemşire:</span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezist:</span></span></td></tr><tr><td style="border-bottom:3px double black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Bölüm Kayıt No:</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Doğum Yeri, Yılı</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Sınıflama<br>[] Büyük<br>[] Orta<br>[] Küçük</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezi Şekli:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Sıra No</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Hastanın Adı:<br><br>TC:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Ameliyatın Adı:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hastalığın Tanısı:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Operatör:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Asistan:</span></span></td><td rowspan="4" style="border-bottom:3px double black; border-left:1px solid black; border-right:3px double black; border-top:none; text-align:left; vertical-align:top; width:313px"><span style="font-size:15px"><span style="color:black">Ameliyatın Evresi:<br><br><br><br><br><br><br>Sonuç:</span></span></td></tr><tr><td style="border-bottom:none; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hasta Kabul No:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black">Soyadı:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Tarihi:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Anatoma Patolojik Tanı:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Kodu:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hemşire:</span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezist:</span></span></td></tr><tr><td style="border-bottom:3px double black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Bölüm Kayıt No:</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Doğum Yeri, Yılı</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Sınıflama<br>[] Büyük<br>[] Orta<br>[] Küçük</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezi Şekli:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Sıra No</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Hastanın Adı:<br><br>TC:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Ameliyatın Adı:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hastalığın Tanısı:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Operatör:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Asistan:</span></span></td><td rowspan="4" style="border-bottom:3px double black; border-left:1px solid black; border-right:3px double black; border-top:none; text-align:left; vertical-align:top; width:313px"><span style="font-size:15px"><span style="color:black">Ameliyatın Evresi:<br><br><br><br><br><br><br>Sonuç:</span></span></td></tr><tr><td style="border-bottom:none; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hasta Kabul No:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black">Soyadı:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Tarihi:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Anatoma Patolojik Tanı:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Kodu:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hemşire:</span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezist:</span></span></td></tr><tr><td style="border-bottom:3px double black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Bölüm Kayıt No:</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Doğum Yeri, Yılı</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Sınıflama<br>[] Büyük<br>[] Orta<br>[] Küçük</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezi Şekli:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Sıra No</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Hastanın Adı:<br><br>TC:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Ameliyatın Adı:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hastalığın Tanısı:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Operatör:</span></span></td><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Asistan:</span></span></td><td rowspan="4" style="border-bottom:3px double black; border-left:1px solid black; border-right:3px double black; border-top:none; text-align:left; vertical-align:top; width:313px"><span style="font-size:15px"><span style="color:black">Ameliyatın Evresi:<br><br><br><br><br><br><br>Sonuç:</span></span></td></tr><tr><td style="border-bottom:none; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hasta Kabul No:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black">Soyadı:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Tarihi:</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Anatoma Patolojik Tanı:</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:3px double black; border-right:1px solid black; border-top:none; height:26px; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Kodu:</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:top"><span style="font-size:15px"><span style="color:black"> </span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Hemşire:</span></span></td><td rowspan="2" style="border-bottom:3px double black; border-left:1px solid black; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezist:</span></span></td></tr><tr><td style="border-bottom:3px double black; border-left:3px double black; border-right:1px solid black; border-top:none; height:53px; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Bölüm Kayıt No:</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Doğum Yeri, Yılı</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top; width:117px"><span style="font-size:15px"><span style="color:black">Sınıflama<br>[] Büyük<br>[] Orta<br>[] Küçük</span></span></td><td style="border-bottom:3px double black; border-left:none; border-right:1px solid black; border-top:none; text-align:left; vertical-align:top"><span style="font-size:15px"><span style="color:black">Anestezi Şekli:</span></span></td></tr></tbody></table>