Pdf-faylidagi rasmiy manba

16 yoshgacha bo‘lgan nogiron bolaga beriladigan

TIBBIY XULOSA
____-son
20___ y. “__” __________	___________ tuman (shahar)
1. Bolaning familiyasi, ismi, otasining ismi_______________________________ _______________________________________________________________________.
2. Tug‘ilgan yili (oyi, sanasi) ____________________________________________
3. Bolaning ota-onasi yoki ularning o‘rnini bosuvchi shaxslarning F.I.Sh. _______________________________________________________________________ _______________________________________________________________________.
4. Ota-ona yoki ularning o‘rnini bosuvchi shaxslarning doimiy yashash joyi _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
5. Tashxis (kasallikning nomi, patologik holati): ____________________________
Asosiy ________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________
Asorati _______________________________________________________________
Qo‘shimcha tashxis ________________________________________________________
6. Xulosa: kasallik (patologik holat) _______________________________________ ___________ taalluqli bo‘lim _____________ bandga __________ band bo‘limiga ________________________ tegishliligi
7. Xulosaning haqiqiyligi ________________________gacha
8. Navbatdagi tibbiy ko‘rikdan o‘tish sanasi _______________ gacha
9. Bolaning protez-ortopediya mahsulotlari va reabilitatsiya texnik vositalarga muhtojligi:
Ha (nomi) ______________________________________________________________
Yo‘q.
TMK raisi	___________________________________
	^(F.I.Sh., imzosi)
TMK a’zolari	___________________________________
	^(F.I.Sh., imzosi)
M.O‘.
20__ y. “__” ______________