Proforma for STEMI AMI is defined as Arrival Date/ERC Date/CCU CCU Hrs


Age Sex R/N

Bed No Address

Type of AMI Lead I Lead II Lead III aVR aVL aVF V1 V2 V3 V4 V5 V6 Htn CVD RF DM SM betal Lipids F/H .

RF Presenting symptom PVD CVD Chest pain breathlesness collapse Cardiac arrest Other .

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