Санкт-Петербургская государственная медицинская академия имени И

Anamnesis vitae:

1. 
   Go’daklik, bolalik va o’smirlik davri:________________________________________________
   

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2. 
   Jinsiy va oilaviy xayoti:___________________________________________________________
   

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3. 
   Turmush sharoiti:
   

Uy sharoiti: ___________________________________________________________________ __________________________________________________________________________________

Moddiy sharoiti: _______________________________________________________________

Ovqatlanishi:____________________________________________________________________________________________________________________________________________________

4. 
   Mexnat faoliyati: _________________________________________________________________
   

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5. 
   Zararli odatlari: _________________________________________________________________
   

6. 
   Bemorning boshidan kechirgan kasalliklari: __________________________________________
   

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Nasliy ma’lumotlar: ____________________________________________________________ __________________________________________________________________________________

7. 
   Allergologik anamnez:______________________________________________________________
   

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8. Epidemiologik anamnez: _____________________________________________________________ _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5.