ES.FR.007 - HASTA MUAYENE DEĞERLENDİRME FORMU

Doküman Kodu: ES.FR.007
Yayın Tarihi: 14.02.2019
Revizyon Tarihi: 02.09.2022
Revizyon No: 2

Paylaş:

DİKKAT! Buradaki bilgiler sağlık profesyonelleri için hazırlanmıştır. Arama motorları vs. ile bu sayfadaki bilgilere ulaştıysanız, sağlık profesyonellerine danışmadan, sadece buradaki bilgiler ile hareket etmeyiniz.

Doküman Önizlemesi

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Demo Hastanesi (Prokalite.Com) HASTA MUAYENE DEĞERLENDİRME FORMU

Doküman Kodu: ES.FR.007

Yayın Tarihi: 14.02.2019

Revizyon Tarihi: 02.09.2022

Revizyon No: 2

Sayfa: Otomatik

Hastanın
Adı-Soyadı:
Yaşı:
Tanı:
Tarih:
	ATEŞ:	NABIZ:	HT:
GD: HASTA MUAYENESİ			TARİH:
			DR. KAŞE / İMZA
	ATEŞ:	NABIZ:	HT:
GD: HASTA MUAYENESİ			TARİH:
			DR. KAŞE / İMZA
	ATEŞ:	NABIZ:	HT:
GD: HASTA MUAYENESİ			TARİH:
			DR. KAŞE / İMZA
	ATEŞ:	NABIZ:	HT:
GD: HASTA MUAYENESİ			TARİH:
			DR. KAŞE / İMZA

Evde Sağlık Hizmetleri bölümündeki diğer form örnekleri

Tümünü gör (33)

ES.FR.003 HASTA TEDAVİ PLANI FORMU ES.FR.004 BASI YARASI TAKİP VE DEĞERLENDİRME FORMU ES.FR.005 EVDE SAĞLIK HİZMETİNE KABUL EDİLEN HASTA DEĞERLENDİRME FORMU ES.FR.006 HASTA SONLANDIRMA FORMU ES.FR.008 MNA (Mini Nutritional Assessment) DEĞERLENDİRME FORMU (Yaşlı Hastalar İçin) ES.FR.009 STRONGKİDS DEĞERLENDİRME FORMU ES.FR.010 HASTA NAKİL FORMU ES.FR.011 BARTHEL İNDEKSİ FORMU

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<table style="border-collapse: collapse; width: 882px;" class=" cke_show_border" cellspacing="0"><tbody><tr><td style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">Hastanın</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:1px solid black; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:1px solid black; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:35px; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">Adı-Soyadı:</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><br></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:21px; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">Yaşı:</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><br></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:21px; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">Tanı:</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span><br></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><br></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:21px; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">Tarih:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:21px; text-align:center; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">ATEŞ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">NABIZ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">HT:</span></strong></span></td></tr><tr><td style="border-bottom:none; border-left:1px solid black; border-right:none; border-top:none; height:20px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">GD: HASTA MUAYENESİ</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">TARİH:</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:86px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">DR. KAŞE / İMZA</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:21px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">ATEŞ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">NABIZ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">HT:</span></strong></span></td></tr><tr><td style="border-bottom:none; border-left:1px solid black; border-right:none; border-top:none; height:20px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">GD: HASTA MUAYENESİ</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">TARİH:</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:98px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">DR. KAŞE / İMZA</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:21px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">ATEŞ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">NABIZ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">HT:</span></strong></span></td></tr><tr><td style="border-bottom:none; border-left:1px solid black; border-right:none; border-top:none; height:20px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">GD: HASTA MUAYENESİ</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">TARİH:</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:87px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">DR. KAŞE / İMZA</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:21px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">ATEŞ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">NABIZ:</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">HT:</span></strong></span></td></tr><tr><td style="border-bottom:none; border-left:1px solid black; border-right:none; border-top:none; height:20px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">GD: HASTA MUAYENESİ</span></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:none; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">TARİH:</span></strong></span></td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:none; border-top:none; height:103px; vertical-align:middle; width:180px"><span style="font-size:13px"><span style="color:black">&nbsp;</span></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">&nbsp;</span></strong></span></td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; text-align:center; vertical-align:middle; width:180px"><span style="font-size:13px"><strong><span style="color:black">DR. KAŞE / İMZA</span></strong></span></td></tr></tbody></table>