AİLE PLANLAMASI EĞİTİM KAYIT FORMU

Örnek Doküman

EY.FR.042 - AİLE PLANLAMASI EĞİTİM KAYIT FORMU

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Demo Hastanesi (Prokalite.Com) AİLE PLANLAMASI EĞİTİM KAYIT FORMU

Doküman Kodu: EY.FR.042

Yayın Tarihi: 16.11.2022

Revizyon Tarihi: -

Revizyon No: -

Sayfa: Otomatik

EĞİTİM KONULARI
■Kondom yönteminde eğitimi				AİLE PLANLAMASI EĞİTİMİNDE KİTAPÇIK VE BROŞÜR VERİLMİŞTİR.
■Rahim içi araç yöntemi
■Gebeliği önleyici 1 aylık ve 3 aylık iğneler
■Gebeliği önleyici haplar
■Kola takılan çubuk (İmplant)
■Vajinal halka
■Cerrahi yöntemler (Tüplerin bağlanması)
EĞİTİM TARİHİ	EĞİTİMİ VEREN		EĞİTİMİ ALAN GEBE
EĞİTİM TARİHİ	AD SOYAD	İMZA	AD SOYAD	İMZA

<table cellspacing="0" style="border-collapse:collapse; width:884px" class=" cke_show_border"><tbody><tr><td colspan="6" style="border-color:black; border-style:solid; border-width:1px; height:37px; vertical-align:middle; width:878px">EĞİTİM KONULARI</td></tr><tr><td colspan="4" style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:1px solid black; height:20px; text-align:left; vertical-align:middle; width:686px">■Kondom yönteminde eğitimi</td><td colspan="2" rowspan="7" style="border-color:black; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:188px">AİLE PLANLAMASI EĞİTİMİNDE KİTAPÇIK VE BROŞÜR VERİLMİŞTİR.</td></tr><tr><td colspan="4" style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; text-align:left; vertical-align:middle; width:686px">■Rahim içi araç yöntemi</td></tr><tr><td colspan="4" style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; text-align:left; vertical-align:middle; width:686px">■Gebeliği önleyici 1 aylık ve 3 aylık iğneler</td></tr><tr><td colspan="4" style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; text-align:left; vertical-align:middle; width:686px">■Gebeliği önleyici haplar</td></tr><tr><td colspan="4" style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; text-align:left; vertical-align:middle; width:686px">■Kola takılan çubuk (İmplant)</td></tr><tr><td colspan="4" style="border-bottom:none; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; text-align:left; vertical-align:middle; width:686px">■Vajinal halka</td></tr><tr><td colspan="4" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:20px; text-align:left; vertical-align:middle; width:686px">■Cerrahi yöntemler (Tüplerin bağlanması)</td></tr><tr><td rowspan="2" style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:42px; text-align:center; vertical-align:middle; width:185px">EĞİTİM TARİHİ</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:341px">     EĞİTİMİ VEREN</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:344px">  EĞİTİMİ ALAN GEBE</td></tr><tr><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; height:21px; text-align:center; vertical-align:middle; width:171px">AD SOYAD</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:167px">İMZA</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:153px">AD SOYAD</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:188px">İMZA</td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:102px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:84px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:102px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:84px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:102px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:84px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:none; border-top:none; vertical-align:middle; width:102px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:84px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr><tr><td style="border-bottom:1px solid black; border-left:1px solid black; border-right:1px solid black; border-top:none; height:33px; vertical-align:middle; width:185px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:171px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:167px"> </td><td style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:none; vertical-align:middle; width:153px"> </td><td colspan="2" style="border-bottom:1px solid black; border-left:none; border-right:1px solid black; border-top:1px solid black; vertical-align:middle; width:188px"> </td></tr></tbody></table>

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Eğitim Yönetimi - Form

EY.FR.042 - AİLE PLANLAMASI EĞİTİM KAYIT FORMU

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