Latent sil yoki ximioprofilaktika davosi olayotgan bemorlar nazorat varog`I


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Familiyasi


LATENT SIL YOKI XIMIOPROFILAKTIKA DAVOSI OLAYOTGAN BEMORLAR NAZORAT VAROG`I



Familiyasi:______________________________ Ismi:_________________________Sharifi _______________________________
Tug`ilgan yili: _____/_____/_________ Bemor vazni : ______ Jinsi: Erkak □ Ayol BTSJ chandiq: yo`q □ 1 ta □ 2 ta □
Doimiy yashash manzili:______________________________________________________________________________________
Yaqin qarindoshi yoki bolaning ota-onasi: ________________________________________________________________________




0 guruhi: tuberkulyoz bilan kasallanish havfi yuqori bo`lgan shaxslar

A guruh

  1. ST+bemorlar bilan muloqotda bo`lgan mantu sinamasining natijasi manfiy kattalar;

  2. Bakteriya ajratishdan qat’iy nazar o`pka tuberkulyozining faol shaklidagi bemorlar bilan muloqotda bo`lgan Mantu sinamasining natijasi manfiy 0-18 yoshdagi bolalar

B guruh

  1. LTI li shaxslar;

  2. TB ni birlamchi infitsirlangan (viraj), Mantu sinamasining natijasi musbat bolalar;

  3. BTSJ vaktsinatsiyasi asoratlangan bolalar




Tekshiruv natijalari
Mantu sinamasi qo`yilganmi xa yo`q sinama qo`yilgan sana: ____/____/_______seriya raqami _________natijasi____________
Diaskintest sinama qo`yilgan sana: ____/____/_______ seriya raqami_____/_____/_________ natijasi____________
Obzor rentgenografiya, flyuorografiya yoki MSKT xa yo`q sana: ____/____/__________ natijasi____________
_____________________________________________________________________________________________________ ______________________________________________________________________________________________________ ________________________________________________________________________________________________________
Mikroskopiya topshirganmi xa yo`q sana: ____/____/________ natijasi__________ Laborator nomeri ____________
Gene-Xpert topshirganmi xa yo`q sana: ____/____/________ natijasi__________ Laborator nomeri ____________






Davolash jarayonini kechishi
“D” nazoratga olingan sana ____/____/________“D” nazoratga chiqarilgan sana ______/______/_________ Bemor tartib raqami № _________
Dori qabul qilayotgan joyi : _________________________________________ dorini ichishni boshlagan sana: _______/_______/___________
Dorini nojo`ya ta’siri kuzatildimi xa yo`q ____________________

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