KADIN DOĞUM DOĞUM EYLEMİ GÖZLEM FORMU

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DH.FR.006 - KADIN DOĞUM DOĞUM EYLEMİ GÖZLEM FORMU

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Demo Hastanesi (Prokalite.Com) KADIN DOĞUM DOĞUM EYLEMİ GÖZLEM FORMU

Doküman Kodu: DH.FR.006

Yayın Tarihi: 11.04.2013

Revizyon Tarihi: 11.08.2022

Revizyon No: 1

Sayfa: Otomatik

ADI SOYADI: ………………………………………………………...............................

G: P: Y: A: D&C:

GEBELİK HAFTASI:

ÖZELLİKLER:

TARİH

SAAT

KONTR

ÇIKIŞ

SİLİNME
AÇIKLIK

POŞ

ÖNDEKİ
KISIM

DOĞUMUN 2. EVRESİ

DOĞUMUN TARİHİ: ………………………………….. SAATİ: …………………...…...……………………

SÜRE: ………………………………… İNDUKSİYON VAR …………………… YOK …………………………

DOĞUM ŞEKLİ: ……………………………………………………………………………………………………

BEBEĞİN CİNSİ: ……………………………. APGAR 1. DAK …………………. 5. DAK …………

ANOMALİ: ……………………………………………………………………………………………………………

TRAVMA: ……………………………………………………………………………………………………………

ŞEF DR.: …………….

UZMAN DR.: ……………

ASİSTAN DR.:………….

DOĞUMUN 3. EVRESİ

PLACENTANIN AYRILMA ŞEKLİ: …………………………………………SÜRESİ: ………………………

KANAMA MİKTARI: …………………………………………………………………………………………………..

POSTPARTUM KANAMA

EPİZYO: ………………………………….. PERİNE YIRTIĞI: ………………………………….

DİĞER KOMPLİKASYONLAR: ………………………………………………………………………

…………………………………………………………………………………………………………………………

ŞEF DR.: ………….

UZMAN DR.: ……………

ASİSTAN DR. ………….

MÜDAHALE NO: …………

AMELİYAT MÜDAHALE NOTU

ENDİKASYON: ………..

TARİH: …………………………..

SAAT: …………

…………………………………………………………………………………………………………………………

………………………………………………………………………..

ŞEF DR.: ………………….

………………………………………………………………………..

UZMAN DR.: ………….

………………………………………………………………………..

ASİSTAN DR.: ………….

<table style="border-collapse:collapse" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="10" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:27px; vertical-align:middle; width:300px">ADI SOYADI: ………………………………………………………...............................</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:68px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:84px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom; width:33px"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">G:                             P:                           Y:                            A:                              D&C:</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"> </td></tr><tr><td colspan="4" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">GEBELİK HAFTASI:</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"> </td></tr><tr><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">ÖZELLİKLER: </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:bottom"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:31px; text-align:center; vertical-align:middle">TARİH</td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle">SAAT</td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle">KONTR</td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle">ÇIKIŞ</td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:99px">SİLİNME AÇIKLIK</td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle">POŞ</td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle; width:117px">ÖNDEKİ KISIM</td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:22px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr><tr><td colspan="3" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:27px; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="3" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:bottom"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:bottom"> </td><td colspan="4" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; text-align:center; vertical-align:middle"> </td></tr></tbody></table><div style="page-break-after:always"> </div><table style="border-collapse:collapse" class=" cke_show_border" cellspacing="0"><tbody><tr><td colspan="5" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:40px; text-align:center; vertical-align:middle; width:165px">DOĞUMUN 2. EVRESİ</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:20px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:16px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:68px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:33px"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:84px"> </td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:14px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">DOĞUMUN TARİHİ: …………………………………..  SAATİ: …………………...…...……………………</td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">SÜRE: ………………………………… İNDUKSİYON VAR …………………… YOK …………………………</td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">DOĞUM ŞEKLİ: ……………………………………………………………………………………………………</td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">BEBEĞİN CİNSİ: ……………………………. APGAR           1. DAK …………………. 5. DAK …………</td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">ANOMALİ: ……………………………………………………………………………………………………………</td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">TRAVMA: ……………………………………………………………………………………………………………</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ŞEF DR.: …………….</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">UZMAN DR.: ……………</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ASİSTAN DR.:………….</td></tr><tr><td colspan="5" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:29px; text-align:center; vertical-align:middle">DOĞUMUN 3. EVRESİ</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">PLACENTANIN AYRILMA ŞEKLİ: …………………………………………SÜRESİ: ………………………</td></tr><tr><td colspan="15" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">KANAMA MİKTARI: …………………………………………………………………………………………………..</td></tr><tr><td colspan="5" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">POSTPARTUM KANAMA</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="13" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">EPİZYO: ………………………………….. PERİNE YIRTIĞI: ………………………………….</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="13" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">DİĞER KOMPLİKASYONLAR: ………………………………………………………………………</td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ŞEF DR.: ………….</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">UZMAN DR.: ……………</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ASİSTAN DR. ………….</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="4" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">MÜDAHALE NO: …………</td></tr><tr><td colspan="6" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:28px; text-align:center; vertical-align:middle">AMELİYAT MÜDAHALE NOTU</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="4" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ENDİKASYON: ………..</td></tr><tr><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="6" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">TARİH: …………………………..</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">SAAT: …………</td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="14" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">…………………………………………………………………………………………………………………………</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td></tr><tr><td colspan="10" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">………………………………………………………………………..</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ŞEF DR.: ………………….</td></tr><tr><td colspan="10" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">………………………………………………………………………..</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">UZMAN DR.: ………….</td></tr><tr><td colspan="10" style="border-bottom:none; border-left:none; border-right:none; border-top:none; height:24px; vertical-align:middle">………………………………………………………………………..</td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle"> </td><td colspan="3" style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle">ASİSTAN DR.: ………….</td></tr></tbody></table>

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Doğum Hizmetleri - Form

DH.FR.006 - KADIN DOĞUM DOĞUM EYLEMİ GÖZLEM FORMU

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