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EXAMEN DE BILAN

Data_________________
NUME I PRENUME: ______________________________CNP________________
VRSTA:
____________________
OCUPAIA:
DOMICILIUL : ______________________________________________________
ANAMNEZA SIMPTOME:
______________________________________________________
APF______________________________________________________
APP______________________________________________________
AHC______________________________________________________
CVM______________________________________________________
SCURT ISTORIC - EPISOD ACTUAL____________________
EX. OBIECTIV
GREUTATE:
____________________
NLIME:
____________________
INDICE MAS CORPORALA: ____________________
Tegumente i mucoase: _______________________________________________________
Grupe ganglionare:
________________________________________________________
Sistem osteoarticular: ________________________________________________________
Aparat respirator:
________________________________________________________
Aparat cardiovascular: TA:__________________________; AV:______________________
Zgomote cardiace__________________________________________
Modificri orificiale________________________________________
Artere___________________________________________________
Vene____________________________________________________
Aparat digestiv:
Cavitate bucal:___________________________________________
Ficat:____________________________________________________
Splin:__________________________________________________
Tranzit intestinal:__________________________________________
Aparat urogenital:
Lojerenale______________________________________________
Mciuni_________________________________________________
Organe genitale ext.______________________________________
Sistem nervos:
SNC_________________________________________________
ROT_________________________________________
Organe de sim____________________________________
Sistem endocrin: ______________________________________________________
CONCLUZII:________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
RECOMANDRI:____________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Data urmatorului bilan: