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Tekshiruv turlari
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Mutaxassis shifokor tekshiruvining ma’lumotlari va diagnozi
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Birlamchi
tibbiy ko‘rik
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Yakuniy
tibbiy ko‘rik
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1
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2
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3
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1. Shikoyatlar va anamnezi
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2. O‘tkazilgan kasalliklar va jarohatlar
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3. Antropometrik ko‘rsatkichlar:
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Bo‘yi
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Tana vazni
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Dinamometriya:
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O‘ng qo‘l
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Chap qo‘l
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Gavdani tik turish paytida
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�
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4. Jarrohlik tekshiruvi natijalari:
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Umumiy jismoniy rivojlanishi
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Teri va ko‘rinadigan shilliq qavatlar
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Limfa tugunlari
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Suyak-mushak tizimi
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Periferik tomirlar
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Siydik chiqarish va jinsiy tizim
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Anus
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Diagnoz:
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Xulosa
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Sana, jarrohning imzosi, familiyasi, ismi, otasining ismi
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5. Ichki a’zolar tekshiruvi natijalari:
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Oziqlanish
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Endokrin tizimi
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Yurak: chegaralari
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Tonlar
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Faoliyat sinamalari
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Puls
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Arterial bosim
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Nafas a’zolari
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Ovqat hazm qilish a’zolari
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Jigar
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Taloq
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Buyraklar
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Diagnoz:
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Xulosa
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Sana, terapevtning imzosi, familiyasi, ismi va otasining ismi
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6. Asab tizimi tekshiruvi natijalari:
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Bosh-miya nervlari
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Harakat faoliyati
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Reflekslar
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Sezish
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Vegetativ asab tizimi
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Diagnoz:
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Xulosa
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Sana, nyevropatologning imzosi, familiyasi, ismi vaotasining ismi
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7. Ruhiy holatni tekshiruv natijalari:
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Ong
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Diqqat-e’tibor
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Xotira
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Tafakkur
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Intellekt
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Hissiy-irodaviy faoliyat
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Diagnoz:
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Xulosa
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Sana, psixiatrning imzosi, familiyasi, ismi va otasining ismi
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8. Ko‘rish a’zosining tekshiruv natijalari
Rang ajratish (Rabkin bo‘yicha)
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Ko‘rish o‘tkirligi korreksiyasiz
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O‘ng ko‘z
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Chap ko‘z
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Ko‘rish o‘tkirligi korreksiya bilan
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O‘ng ko‘z
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Chap ko‘z
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Refraksiya skiaskopik
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O‘ng ko‘z
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Chap ko‘z
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Binokulyar ko‘rish
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Yaqqol ko‘rishning eng yaqin nuqtasi
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O‘ng ko‘z
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Chap ko‘z
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Ko‘z yoshi yo‘llari
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Qovoq va kon’yunktiva
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��
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Ko‘z olmalarining joylashuvi, harakatchanligi
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Qorachiq va ularning ta’sirga javobi
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Optik muhitlar
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O‘ng ko‘z
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Chap ko‘z
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Diagnoz:
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Xulosa
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Sana, oftalmologning imzosi, familiyasi, ismi, otasining ismi
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9. LOR-a’zolarning tekshiruv natijalari:
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Nutq
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Burun orqali nafas
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o‘ng
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chap
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Hid bilish
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o‘ng
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chap
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Pichirlab gapirishga eshitish o‘tkirligi
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o‘ng
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chap
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Quloqning barofaoliyati
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o‘ng
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chap
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Vestibulyar apparatining faoliyati (aylanish bilan ikki hissa tajriba)
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Diagnoz:
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Xulosa
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Sana, otolaringologning imzosi, familiyasi, ismi, otasining ismi
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10. Tishlar va og‘iz boshlig‘ining tekshiruv natijalari:
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Tishlash holati
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Og‘izning shilliq qavati
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Tishlar
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Milklar
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Diagnoz:
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Xulosa:
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Sana, stomatologning imzosi, familiyasi, ismi va otasining ismi
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11. Teri tanosil tekshiruv natijalari
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Diagnoz:
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Xulosa
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Sana, dermatovenerologning imzosi, familiyasi, ismi, otasining ismi
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12. Rentgen, tahliliy va boshqa tekshiruvlar hamda boshqa mutaxassis shifokorlarning xulosalari yozuvlari: _________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
13. Harbiy tibbiy komissiyaning birlamchi tibbiy ko‘rik bo‘yicha yakuniy diagnozi:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
14. Harbiy tibbiy komissiyaning birlamchi xulosa va qarorlari:
20____yil “___” _________________________________________________________________________huzuridagi
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(ichki ishlar organi)
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harbiy-tibbiy komissiyasi tomonidan birlamchi tibbiy ko‘rik natijalariga ko‘ra kasalliklar va jismoniy nuqsonlar jadvalining ______ bandi ______ kichik bandi(lari) asosida _____________________________________ ga kirishga
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(akademik litseyning nomi)
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_________________________________.
(yaroqli yoki yaroqsizligi ko‘rsatiladi)
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��Komissiya raisi ___________________________________________________________________________________
(unvoni, imzosi, familiyasi, ismi, otasining ismi)
Komissiya kotibi __________________________________________________________________________________
(unvoni, imzosi, familiyasi, ismi, otasining ismi)
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M.O‘.
| | | | | | | | | | | | | | | | | | | | | | | |
15. Harbiy tibbiy komissiyaning yakuniy tibbiy ko‘rik bo‘yicha diagnozi: _________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
16. Harbiy tibbiy komissiyaning yakuniy xulosa va qarorlari:
20____yil “___” _________________________________________________________________________huzuridagi
| | | | |
(ichki ishlar organi)
| | | |
harbiy-tibbiy komissiyasi tomonidan yakuniy tibbiy ko‘rik natijalariga ko‘ra kasalliklar va jismoniy nuqsonlar jadvalining ______ bandi ______ kichik bandi(lari) asosida _____________________________________ ga kirishga
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(akademik lits?yning nomi)
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_________________________________.
(yaroqli yoki yaroqsizligi ko‘rsatiladi)
| | | | | | | | | | | | | | | | |
Komissiya raisi ___________________________________________________________________________________
(unvoni, imzosi, familiyasi, ismi, otasining ismi)
Komissiya kotibi __________________________________________________________________________________
(unvoni, imzosi, familiyasi, ismi, otasining ismi)
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M.O‘.
| | | | | | | | | | | | | | | | | | | | | | | |
O‘zbekiston Respublikasi Ichki ishlar vazirligi akademik litseylariga o‘qishga kirayotgan o‘quvchilarni tibbiy ko‘rikdan o‘tkazish tartibi to‘g‘risidagi nizomga
6-ILOVA
O‘quvchining sog‘lig‘i holatini tekshirish
DALOLATNOMASI
________________________________________________________________________________________________
(familiyasi, ismi, otasining ismi, tug‘ilgan yili)
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________________________________________________________________________________________________
_______________________________________________________ ichki ishlar organi HTK tomonidan 20____yil “_____” ______________________ dagi ________-son yo‘llanmasi asosida statsionar (ambulator) ravishda _________________________________________________________________________________________
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(davolash-profilaktika muassasasining nomi)
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20____ yil “_____” __________________ dan 20___ yil “______” _________________gacha tekshiruvdan o‘tkazilgan.
Shikoyatlari: _____________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Anamnezi _______________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Obyektiv tekshiruv ma’lumotlari ____________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Maxsus tekshiruvlar natijalari (tahliliy, rentgenologik, uskunaviy va boshqalar) ____________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Diagnoz _________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Davolash-profilaktika muassasasining bosh shifokori __________________________________________________
________________________________________________________________________________________________
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(imzosi, familiyasi, ismi va otasining ismi)
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Tekshiruv o‘tkazgan shifokor ________________________________________________________________________
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(imzosi, familiyasi, ismi va otasining ismi)
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Sana_____________
| | | | | | |
M.O‘.
| | | | | | | | | | | | | | | | | | | | | |
Davolash-profilaktika muassasasining manzili: ________________________________________________________
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O‘zbekiston Respublikasi Ichki ishlar vazirligi akademik litseylariga o‘qishga kirayotgan o‘quvchilarni tibbiy ko‘rikdan o‘tkazish tartibi to‘g‘risidagi nizomga
7-ILOVA
______________________________________(Harbiy-tibbiy komissiyaning nomi
(to‘liq ko‘rsatiladi)
| | | | | | | | | | |
MA’LUMOTNOMA
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20____yil “___” _____________
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_______-son
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________________________________________________________________________________________________
(o‘quvchining familiyasi, ismi, otasining ismi, tug‘ilgan yili)
|
Diagnoz: ________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
Bo‘yi_____ sm, Vazni _____ kg, Ko‘krak aylanasi (tinch holatda) ______ sm.
_______________________________________________________________________________________huzuridagi
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(ichki ishlar organi)
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harbiy-tibbiy komissiyasi tomonidan tibbiy ko‘rik o‘tkazilib, kasalliklar va jismoniy nuqsonlar jadvalining ________ bandi __________________________ kichik bandi(lari) asosida harbiy-tibbiy komissiya tomonidan ______________________________________________________________________________________ deb topildi.
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(o‘qishga qabul qilishga yaroqli yoki yaroqsizligi ko‘rsatiladi)
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Komissiya raisi ___________________________________________________________________________________
(imzosi, familiyasi, ismi va otasining ismi)
Komissiya kotibi __________________________________________________________________________________
(imzosi, familiyasi, ismi va otasining ismi)
| | | | | | | | | | |
M.O‘.
Harbiy-tibbiy komissiyaning manzili ________________________________________________________________
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(Qonun hujjatlari ma’lumotlari milliy bazasi, 16.03.2018-y., 10/18/2982/0901-son)
Do'stlaringiz bilan baham: |
