Documente Academic
Documente Profesional
Documente Cultură
AL REPUBLICII MOLDOVA
ORDIN
mun. Chiinu
_05___februarie___2010
Nr. ____79_____
Cu privire la aprobarea
unor formulare statistice
n temeiul Legii nr. 10-XVI din 03 februarie 2009 privind supravegherea de stat
a sntii publice (Monitorul Oficial al Republicii Moldova, 2009, nr. 67, art. 183) i
n scopul sistematizrii, ntocmirii i utilizrii documentaiei de eviden medical i
controlului aplicrii sanciunilor administrative, n legtur cu intrarea n vigoare a
noului Cod Contravenional, precum i n temeiul p.8 al Regulamentului privind
organizarea i funcionarea Ministerului Sntii, aprobat prin Hotrrea Guvernului
nr.777 din 27 noiembrie 2009 (Monitorul Oficial al Republicii Moldova, 2009,
nr.173, art. 855),
ORDON :
1. Se aprob:
1) Formularul statistic: Hotrrea privind interzicerea/suspendarea, F nr.306/e
2) Formularul statistic: Proces-verbal cu privire la contravenie, F nr. 309/e;
3) Formularul statistic: Prescripie sanitar, F nr. 310/e;
2. Directorul general al Centrului Naional tiinifico-Practic de Medicin
Preventiv (O. Bene), medicii efi ai Centrelor de Medicin Preventiv municipale i
raionale:
1) vor pune n aplicare, ncepnd cu data de 01.03.2010, formularele statistice de
eviden medical, aprobate prin prezentul ordin;
2) vor interzice utilizarea, dup data de 01.03.2010 a formularelor statistice de
model vechi i a celor care nu sunt aprobate de Ministerul Sntii.
3. Se abrog Ordinul Ministerului Sntii nr. 508 din 08.12.2006 cu privire la
aprobarea unor formulare statistice de constrngere administrativ i formularul nr.
306/e Hotrrea privind interzicerea, suspendarea, aprobat prin Ordinul
Ministerului Sntii nr. 139 din 28.05.2002 cu privire la aprobarea formularelor de
eviden medical primar din instituiile medicale.
Controlul ndeplinirii ordinului se atribuie dlui Mihai Magdei, viceministru.
Ministru
Vladimir HOTINEANU
MINISTERUL SNTII
AL REPUBLICII MOLDOVA
ORDIN
mun. Chiinu
_________________2010
Nr. ___________
10-XVI 3 2009
(
, 2009, 67, . 183) ,
,
, .8
777 27 2009 (
M , 2009, 173, . 855),
:
1. :
1)
:
/
, F 306/e;
2) : , F 309/e;
3) : , F 310/e;
2. -
(. O. ),
:
1) , 01.03.2010,
, ;
2) , 01.03.2010
, ,
.
3. 508 08.12.2006
306/e ,
,
139 28.05.2002
.
.
, .
DOCUMENTAIE MEDICAL
Formular
Nr. 306/e
Aprobat de MS al RM
HOTRRE Nr ______
___________________________________________________________________________________________
denumirea teritoriului administrat /
____________________________________________________________________________________________________
numele, prenumele, patronimicul / ..
___________________________________________________________________________________________
denumirea obiectivului, adresa amplasrii / ,
___________________________________________________________________________________________
denumirea documentelor /
am stabilit _________________________________________________________________________________
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n baza art.17, 67 din Legea privind supravegherea de stat a sntii publice nr.10-XVI din
03.02.2009, (Monitorul Oficial al Republicii Moldova, 2009, nr.67, art.183)
. 17, 67
03.02.2009 ( , 2009, 67, . 183)
10-XVI
HOTRSC:
:
____________________________________________________________________________________________
numele, prenumele, funcia / ..
________________________________________________________
_________________________________________________________
_________________________________________________________
semntura /
___________________________________________________________________________________________________
"_______" ______________________20___
Hotrrea a fost emis n _________ exemplare
1._______________________________________________
3.____________________________________________
2._______________________________________________
4.____________________________________________
REPUBLICA MOLDOVA
MINISTERUL SNTII
SERVICIUL DE SUPRAVEGHERE DE
STAT A SNTII PUBLICE
DOCUMENTAIE MEDICAL
Formular nr. 309/e
Aprobat de MS al RM
PROCES-VERBAL
cu privire la contravenie
________________________________________
locul ncheierii /
funcia /
n prezena:
nr. _________, eliberat de oficiul ________ la data de ___________, IDNP _________________, domiciliul
_________________________________________________________________________________________
, ,
_________________________________________________________________________________________
Am constatat, la data de________________, ora ________:
_________________________________________________________________________________________
fapta contravenional, locul i timpul svririi, esena contraveniei / oe , , ,
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Semntura: ___________
gent constatator
___________
___________
ontravenient
__________ __________
martor
martor
_________________________________________________________________________________________
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_________________________________________________________________________________________
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prin care se ncalc ________________________________________________________________________
actul normativ /
ce constituie contravenie, prevzut de art. ________ din Codul Contravenional al Republicii Moldova
..
..
..
Drepturile i obligaiile prevzute de art. 34, 378, 384, 387 i 448 a Codului contravenional al Republicii
Moldova, precum i dreptul de a plti jumtate din amend, dac amenda este pltit n cel mult 72 de
ore de la stabilirea ei, i-au fost explicate contravenientului ________________________________________
semntura /
__________________________________________________________________________________
Martorii __________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Obieciile i probele contravenientului i ale victimei (dac exist)_______________________________
( )
_________________________________________________________________________________________
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_________________________________________________________________________________________
_________________________________________________________________________________________
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La procesul-verbal se anexeaz: ______________________________________________________________
_________________________________________________________________________________________
Examinarea cazului va avea loc la____________________________________________________________
Semntura ___________
___________
ontravenient
gent constatator
___________
victima (cnd exist)
( )
__________
martor
_________
martor
DECIZIE
innd seama de faptele svrite i apreciind existena de date suficiente pentru constatarea
contraveniei prevzute de art. ___________________ al Codului contravenional al Republicii Moldova,
, . ___________________________
__________________________________________________________________________________
numele, prenumele, patronimicul /denumirea, datele persoanei fizice care o reprezint / .. / ,
_________________________________________________________________________________________
n calitate de ______________________________________________________________________________
Domiciliul/sediul(adresa juridic)____________________________________________________________
/
_________________________________________________________________________________________
Conform prevederilor Codului contravenional al Republicii Moldova, art. _________________
a , .
n termen de 30 zile de la comunicare, urmnd ca n acelai termen s se prezinte bonul de plat la CMP
teritorial
30 ,
_________________________________________________________________________________________
localitatea, str., nr./ , ., .
_________________________
raionul/municipiul / /
L..
..
data ______________
semntura /
DOCUMENTAIE MEDICAL
Formular
Nr. 310/e
Aprobat de MS al RM
PRESCRIPIE SANITAR
din _____ __________20____
am verificat executarea prevederilor Legii nr.10-XVI din 03.02.2009 privind supravegherea de stat a
sntii publice i a actelor normative n vigoare ce prevd reglementri din domeniul sntii publice,
efectuat la,
10-XVI 03.02.2009
, ,
___________________________________________________________________________________
denumirea obiectivului, adresa amplasrii / ,
___________________________________________________________________________________
______________________________________________________________
Ca rezultat al controlului s-au constatat urmtoarele_____________________________________________
___________________________________________________________________________________
______________________________________________________________
se vor expune clar i n mod succesiv neajunsurile i nclcrile constatate
___________________________________________________________________________________
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n contextul celor constatate i n scopul remedierii deficienelor,____________________________
,
______________________________________________________________
se indic numele i prenumele persoanei responsabile, funcia / ,
___________________________________________________________________________________
SE PRESCRIE
______________________________________________________________
,
______________________________________________________________
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Termenul de nlturare a neajunsurilor constatate ________________________________________
___________________________________________________________________________________
n cazul neexecutrii prescripiei n termenul stabilit se vor aplica msuri legale de
constrngere, potrivit legislaiei n vigoare.
, .