Tug’ruq tarixi Bemor: Bajardi: Tekshirdi: Buxoro – 2023 yil. Tug’ruqtarixi

Abu Ali ibn Sino nomidagi
BuxoroDavlatTibbiyotInstituti

Kafedra: __________________________________________________

Kafedramudiri: ___________________________________________


Tug’ruq tarixi

Bemor: ________________________________________________________

Bajardi:________________________________________________________

Tekshirdi:______________________________________________________

Buxoro – 2023 yil.

Tug’ruqtarixi
O’qituvchi:_____________________________________________________
Talaba:_________________________________________________________
Kursguruh:_________________________________________________________
Fakultet:_______________________________________________________
Baho:__________________________________________________________

I.Pasportqismi

1. 
   Tug’ruqxonaningnomi:____________________________________________________
   
2. 
   Qabulqilingansana (sanaoyyilvaqt):_____________________________________________________
   
3. 
   Homiladorning FIO:_______________________________________________________
   
4. 
   Yoshi:_____________________________________________________
   
5. 
   Manzili:___________________________________________________
   
6. 
   Ishjoyi:_______________________________________________________
   
7. 
   Oilaviypoliklinikanazorati:__________________________________________________
   
8. 
   Homiladorlik________Tug’ruq:______________________________
   
9. 
   Sanitariyakuzatuvinio’tkazishusuli:_____________________________________________________
   
10. 
    Qabulqilingandagi shikoyatlari:__________________________________________________________________________________________________________
    

KELGANDAGI DIAGNOZI

1. 
   Asosiy:____________________________________________________
   
2. 
   Yondosh:__________________________________________________
   
3. 
   Asoratlar:_________________________________________________