Pdf-faylidagi rasmiy manba

16 yoshgacha bo‘lgan nogiron bolaga beriladigan

TIBBIY XULOSA-KOREShOGI
____-son
20___ y. “__” __________	___________ tuman (shahar)
1. Bolaning familiyasi, ismi, otasining ismi_______________________________ _______________________________________________________________________.
2.Tug‘ilgan yili (oyi, sanasi) _____________________________________________
3. Bolaning ota-onasi yoki ularning o‘rini bosuvchi shaxslarning familiyasi, ismi, otasining ismi (keraklisini chizing) _________________________________ _______________________________________________________________________.
4. Ota-onasining yoki ularning o‘rnini bosuvchi shaxslarning doimiy yashash joyi _______________________________________________________________________ _______________________________________________________________________.
5. Kasallik (patologik holat) _____________________________________________
___________________ taalluqli bo‘lim ________________ bandga_______________
band bo‘limiga _______________________ tegishliligi _______________________ _______________________________________________________________________
Tibbiy ko‘rsatmalar ro‘yxati
20___ y. “___” ________ gacha haqiqiy
Bolaning protez-ortopediya mahsulotlari va reabilitatsiya texnik vositalarga muhtojligi:
Ha (nomi) ______________________________________________________________
Yo‘q.
Qayta ko‘rikdan o‘tish sanasi 20___ y. “___” ______________
TMK raisi	___________________________________
	^(F.I.Sh., imzosi)
TMK a’zolari	___________________________________
	^(F.I.Sh., imzosi)
20 ___ y. “___” __________ tuman (shahar) ijtimoiy ta’minot bo‘limiga yuborildi
Manzili: _______________________________________________________________
Aloqa bo‘limining kvitansiyasi № _________________ dan

16 yoshgacha bo‘lgan bolalarni nogiron deb topish haqida tibbiy xulosa berish tartibi to‘g‘risidagi nizomga
3-ILOVA
Nogiron bolalarga protez-ortopediya mahsulotlari va reabilitatsiya texnik vositalari berish uchun asos bo‘luvchi tibbiy ko‘rsatmalar