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    © All Rights Reserved
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    5 views6 pages

    MẪU KSK

    Uploaded by

    Nhung Tuyết

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 6
    SOY TE HANOI CONG HOA XA HOI CHU NGHIA VIETNAM BENH VIEN DA KHOA Die lip - Ty do- Hanh phic sé: dlsstonsh oKuD GIAY KHAM SUC KHOE ‘Ho va tén (chit in hoa): 4..WAM. WG Gis Nam’ ENOL) Twi 7 SB CMND hoge HO chibu aia doo nn elp mais. al le Tai. Wisin CS oi (aay. Lid him si Kes a3 vTIS$U BENH CUA DOLTUONG KHAM SUC KHOE 1. Tike sepa: | ce ng bt) mic mot tong ede béok: ayn mh, tim mpch, di tho uc 4080, ung the, dng kink i loan im thin, bénh khée: Khong & » C6 oO; ‘Néu 6", 6 nghi eh ou thé én bent 2.Tién sit bin thin: _ Ong (ba) dildang mie bénb, tinh trang bh ndo sau dy khong: Bah tray nig, bénb tim mach, di thio dud, lo, hea phé quin, ung thy, dng kinb, ri logn tim thn, bah kh: khong C6 Oo [Nk *06", ng ahi cy thé ten Be 3. Cy hii knie(nda 6). : 2) Ong (ba) e6 dang dig tr ben gi King? Néu 6, xin iy gt ké ef tube dang ding vi Tita tuong: ') Tia st thai sin (B4i voi phy nd) ‘Toi xin cam doan nhing did Rha 23M. mga. thing Cm tein day hod ton ding vi sy that [Nai dé nghj khdm sire koe theo sy higu bgt chia i. (Kivi ghi rb ho, ten) Fry Mw fay (Theo thing es 14/2013/TT-BYT ngay 06 thang 05 nd 2013 cia BO Trading BD ¥ 16) LKHAM THE LYC Chita 680: a jem; Cin ning Chis6 BM Macht node idniphit?” Huyét dp vo ug Phin Joa thé Ive 1. KHAM LAM SANG Ho tn, chiA ia Bae sf Noi Khoa a) Tan od: Phin loi 1b) Ho hp: Phin Jos lo Tita boa: Phin fo ay Tai-Tienigu: Phd 0 |) Connon Kho Phin ogi |) Thi kin Phin lal le) Tam thi: Phin lai 2. Ngoat kos: Phan hs! 3. Sim phy khoa: as ls - Ket qu kh hile: Khong kin: Mit phi..40/.. Mtr Co kink: Mit pis... Mi ti: |- Cie beh v8 mit (nu 68) | Pi 3. I. TaiMicHong |- Kae qui kh thinh Ive: : Haiti: NGF thug: svnnnnfsnaenms NOithim:. Hai phi: Noi thumg: Gone; N6ithim: |. Céc bgnh v8 tai mi hong (néu 9). |. Phin loi... 6. Réng-Ham-Mgt |- Két qua kim: + Him tn: + Him dui: Phan ogi SGN fesuvie M1. KHAM CAN LAM SANG by Khae (nu 00) * Viem gan B = Giang mai Ngi dung kim 1 Xét nghifm mis s)C8ng thie mau Sb lugng HC: Ml... \ Sb wgng Bach els ld x0 | Sé lugng Titu eb. ill 10 | |b Sink nda mu Budng ma: alan Urbino Creatinin.. Lig. mmol ASAT GOT} ll pnnonALATIGPDEL Cod Tp eo, chee __ciia Bae sf ft Me by Protein: le) Knie (ndu c6): a = |3 Chain oan hinh anh: ini ili = DUDIEGRIEN HOCTAP VA CONG TEC Ha Noi, gi img. im NGUOH KET LUAN TRUONG PHONG KHAM SUC KHOE Bsckl Aguyén Van He SOY TEHA NOL CONG HOA XA HOI CHU NGHLA VIET NAM [BENH VIEN DA KHOA Djclap- Tw do Hanh ph HA DONG S6:AG. 9G OKSK-DKUD < GIAY KHAM SUC KHOE Ho va tn (Chi in oa ah let Gigi: Nam ENO CI Tabi 86 CMND hte H9 chigu: Sa Tal. (ale Chi o hia ti on [Ej do kim ste Khe: he a SU BENH CUA DOL TUONG KHAM SUC KHOE {ng (ba) mie met tong ee bg truyéa nim, ang thy, dg Kink, log tim th, ba Ke: Ep lp ngiy UE SE) mach, dai thio » 06 oO; No 8" 8 high ct tn ba Tilman thins ; {ng (bi) dang me Ben, inh ane bono su dy Kg: Bénh tryén ni, bn tim sngch i thio dng. lo, hen én, ang th, ng kin, ri log tim thn, bea Ke aokhing ») 6 O. Néu “c6", 8 nghj eh cw thé tén bgnh 3. Ci hoi Ke (au 6): 8) Ong (bi) e6 dang diéu ri bénh gi King? Néu e6, xin hay ligt ke ede thube dang ding va lida tugng: ? 0) Tid i thai Sin (D8; v6 phy nd) ond. Toixincam dom ahing duke. mgd thing mdi. 268 teén dy hod adn ding vi sy tht ali Hise pasha theo sy ida Bit ea ook ne Kad Hip Lé Ned (Theo thing nes 14/2013/TT-BYT ngay 06 thang 05 ndm 2013 esa BO Trwdng BO Y 1) LKHAM THE LC Chit ea: vesnoneans Cin ning: Mach nel etdiniphit; ” Huyét dp: basa Phan Jogi thé Ive: 3 1. KHAM LAM SANG «kg; Chi s6 BML mm Noi dung kam b) HO hips. Phin losis fey Tieu Phin los (a) Tagn-Ti igus Phan losi \4) Co-xuong:khop: Phin loai |e) Thin kin: 2) Tun hota... hia lost fe Phin lai 2. Neos Khoa Phin lost Sin py koa: Phi lsi 4. ait: | Kak gua km th ye: Khang kinks Mi ph % Mita: ip Cokin Mitt: che ben v8 mit (nd: | Pat oa: Is. Ta MaLttong -Két qud Kho hin ye: [Tai tei: NGF thug: nnfrnee MNGi thi: [ai phi: Nt hung: Mit pha. w |- Phin loa (6. Ring-Ham-Mit | KEt qua km: + Hm tré Him di | Hg tie, chiriy so; NOL HM anche ‘cia Bic sf IIL KHAM CAN LAM SANG Noi dung Khim 6 lugng Bgeh ei $6 hugng Tu eu: Ib Sinh hoa mau: Burg mau: Uenelummal ASAT (GOT) il |b) Knde (nu: Viem gan B = Giang mai Hi ta, chek Se Yo Mi, by Protein Je) Kh (néu 6) Gh IV. KET LUAN 1. Phin log ste kde: 2. Cle bah, tt (néu 6): HocTirviciye 7 ANGI nga thing. rm NGUOI KET LUAN (shir ig in) TRUONG PHONG KHAMSUCKHOE BK Apayin Van Het SOY TR HA NOL CONG HOA XA HOI CHU NGHTA VIET NAM BENH VIEN DA KHOA Doel ‘Ty do -Haah phic HA BONG sisclhsINSS.JGKSK-DRMD GIAY KHAM SUC KHOE Li. Ho va ten (Chit hoa): ni Gigi: Nam O) No Tush S&CMND hoge HG chigu: i. Sel ney ns Ly do Khim Se Khe ono Jong (bi) mic m@t trong ede bénh: truydn nil, tim mgch, di thio ung thu, dng Kinh i logn tim thin, bh kde: ») 66 Néu*c6", 8 nghi ghi ew hétén dfn... 2. Tién sir bin thin: Ong (ba) dtvdang me bénh, tinh trang bénh no sau diy khéng: Bén truyn nh, bn im mach, dai tho ding, lo, hen phé quin, ung thu, dng kin, bi loan tim th, béah Khe: aKhdag » 6 a: [Néu “co 8 nghi ghi ey thé én bg: 3. Caw hot khde (néu 6): : 8) Ong (bi) 6 dang did tj ben 3 Khding? Nu 6, xin hay ligt KE ea thube dang ding vi bu lug: 1) Ta thal sin (B31 wa py ny 3. Téi xin cam doan nhiing diéu khai HEN. my As. thing... wendy ining a gh kh sc kde oorheble cnt sei bho (ho thing ned 1/20137°T-BYT gy 06 hing OS nam 2013 cB Trin BG Ye) LKHAM THE LC ‘Chigaeao: cM} CM RINE! vseessse RBS Chi 8b BME: Math sonewnd delimit,” Huy pnd fodboons MME Phin logi thé Ie: Z 1, KHAM LAM SANG iN pun rhinos boxe ri reste rin ee hin cone

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