Щзбекистон Республикаси

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СТОМАТОЛОГ КЎРИГИ

ДЕРМАТОВЕНЕРОЛОГ КЎРИГИ
Сана________Шикояти_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Анамнез:__________________________________________________________________________________________________________________________________________________________________________
Тери ва шиллиқ пардаларнинг ҳолати: _______________________________________________________
Тошмалар характери_____________________(тарқоқ ёки чегараланган)___________________________
жойлашган жойлари, уларнинг ҳолати (ўткир ёки сурункали) __________________________________
________________________________________________________________________________________
Тошма элементлари (папула, доғ, пустула, пуфакча,пуфак, дўмбоғча ва ҳоказо)____________________
_________________________________________________________________________________________
Айрим характерли белгилар ( симптомлар) _______________________________________________ ____
_________________________________________________________________________________________
Субъектив аломатлар_______________________________________________________________________
Лимфа тугунлари__________________________________________________________________________
Ўтказиладиган муолажалар_________________________________________________________________
Ташхис___________________________________________________________________________________Тавсия___________________________________________________________________________________
Шифокор (Ф.И.Ш) _______________________________________________________________________
Имзо ва шахсий муҳр___________________________________________________________________

СТОМАТОЛОГ КЎРИГИ
Сана________Шикояти_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Анамнез:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Оғиз бўшлиғи шиллиқ пардаларнинг ҳолати:__________________________________________________
Тиш формуласи

8	7	6	5	4	3	2	1	1	2	3	4	5	6	7	8

8	7	6	5	4	3	2	1	1	2	3	4	5	6	7	8

Ўтказиладиган муолажалар__________________________________________________________________

__________________________________________________________________________________________________________________________________________________________________________________
Ташхис_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Тавсия____________________________________________________________________________________________________________________________________________________________________________

Шифокор (Ф.И.Ш) _______________________________________________________________________

Имзо ва шахсий муҳр______________________________________________________________________

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