O’zbekiston Respublikasi Sog’liqni Saqlash Vazirligi Abu Ali Ibn Sino nomidagi Buxoro Davlat Tibbiyot Instituti

O’zbekiston Respublikasi Sog’liqni Saqlash Vazirligi
Abu Ali Ibn Sino nomidagi Buxoro Davlat Tibbiyot Instituti

Fakultet_________________________________________________________

Kafedra;______________________________________________________________________________________________________________________

KASALLIK

TARIXI

Tekshirdi;_________________________________

Bajardi;__________________________________
Buxoro-2021

Muassasa nomi; __________________________________________________

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Bo’lim nomi; ____________________________________________________
Palata N; __________________
Bemor yotqizilgan sana; _______________________________________
Bemor chiqarilgan sana; _______________________________________
Pasport qismi
Bemor F.I.Sh.; ______________________________________
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Tug’ilgan yili, sanasi; _________________________________
Doimiy turar joyi;____________________________________
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Ish joyi, kasbi, lavozimi; ______________________________
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Bemor qayerdan yuborilgan; ___________________________
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Yo’llanmadagi diagnoz; _______________________________
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Qabulxonada qo’yilgan diagnoz; ________________________
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Klinik diagnoz; ______________________________________
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Shikoyatlari _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Anamnesis Morbi ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Anamnesis Vitae _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Status Preasent Objectivus
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Nafas Olish Sistemasi
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Yurak Qon – Tomir Sistemasi
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Ovqat Hazm Qilish Sistemasi
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Siydik Ajratish Sistemasi
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Nevrostatus
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Taxminiy Diagnoz
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Tekshirish rejasi
____________________________________________________________________________________________________________________________________________________________________________________________________________Tekshirish natijalari
Umumiy qon tahlili

Ko’rsatkichlar	natijalar (birligi bilan)	Ko’rsatgichlar	natijalar (birligi bilan)

Biokimyoviy qon tahlili

Ko’rsatkichlar	natijalar (birligi bilan)	Ko’rsatgichlar	natijalar (birligi bilan)

Umumiy siydik tahlili

Ko’rsatkichlar	natijalar (birligi bilan)	Ko’rsatgichlar	natijalar (birligi bilan)

Qo’shimcha tekshirish natijalari

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Klinik tashxis va uni asoslash
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Klinik tashxis; ______________________________________
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Talaba;__________________________ imzo; ____________

Davolash rejasi

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Kundalik
Sana; ________________________

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Sana; __________________________
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