bemorning tibbiy baxnomasi

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shzbekiston respublikasi format a–4 o'zbekiston respublikasi sog'liqni saqlash vazirligi ______________________________ muassasa nomi o'zbekiston respublikasi sog'liqni saqlash vazirining 2017 yil 25 dekabrdagi № 777-sonli buyrug'i bilan tasdiqlangan 003- raqamli tibbiy xujjat shakli bemorning tibbiy bayonnomasi № ____________ kasalxonaga yotqizilgan kun __________________________ vaqti______________ kasalxonadan chiqarilgan kun_________________________vaqti______________ __________________________bo'limi, xona №_____________________________ bo'limga_____________________________________________________________ ___________________________________________________________ o'tkazilgan ______________________________________kun yotib davolangan______________ bemorni olib yurish turlari: aravachada, zambilda, o'zi yura oladi (chizing) qon guruhi______________________rezus mansubligi________________________ dorilarning nojo'ya ta'siri_______________________________________________ _______________________________________________________________________ (dorining nomi, nojo'ya ta'sirning ko'rinishi) _______________________________________________________________________ 1. familiyasi, ismi, otasining ismi___________________________________________________ ______________________________________________2. jinsi_______________ 3. tug'ilgan sana: kun_____oy__________________yil __________ 4. bo'yi____________, vazni ____________, tana harorati __________________ 5. doimiy yashash joyi: shahar, qishloq (chizing) ___________________________________________________________________ (yashash joyi ko'rsatilsin, viloyat va tumanlardan kelganlar uchun manzili va yaqin ___________________________________________________________________ qarindoshlarining yashash joyi va telefon raqamlari ko'rsatilsin) 6. ish joyi, kasbi, lavozimi____________________________________________ ________________________________________________________________________ (o'quvchilar uchun-o'qish joyi: bolalar uchun

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-bolalar muassasasining nomi, ___________________________________________________________________ nogironlar uchun-nogironlikning turi va guruhi; urush nogironi ___________________________________________________________________ ha, yo'q) 7. bemor qaerdan yuborilgan______________________________________________ (davolash muassasasining nomi) 8. kasalxonaga shoshilinch ravishda keltirilgan: ha, yo'q__________________________ qanday transportda____________________________________________________ kasallik boshlangandan so'ng o'tgan vaqt, jarohatdan so'ng, rejali ravishda (chizing) 9. bemor yo'llanmasidagi tashhis__________________________________________ ___________________________________________________________________ ___________________________________________________________________ 10. qabulxonada qo'yilgan tashhis___________________________________________ 11. kasalxonada qo'yilgan tashhis kasallik aniqlangan sana shifokor imzosi 12. kasalxonada qo'yilgan yakuniy tashhis a) asosiy_____________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ b) asosiy kasallikning asorati_____________________________________________ ____________________________________________________________________ v) aniqlangan hamroh kasalliklar___________________________________________ ____________________________________________________________________ __________________________________________________________________ 13. mazkur yil davomida shu kasallik bo'yicha kasalxonaga yotishi: birinchi marta,qayta (chizing) hammasi bo'lib______________________________marta 14. jarrohlik operatsiyalari, og'riqsizlantirish usullari va operatsiyadan keyingi asoratlar operatsiya nomi vaqti, soati og'riqsizlantirish usuli asoratlari 1. 2. 3. operatsiya qiluvchi_________________________________ 15. davolashning boshqa turlari (ko'rsating)________________________________

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__ ____________________________________________________________________ 16.mehnatga yaroqsizliq varag'i yoki ma'lumotnoma: №__________________________dan ___________________gacha №_____________________dan_________________gacha 17. davolash natijasi: kasalxonadan javob berildi: tuzaldi, bir oz yaxshilandi, o'zgarishsiz, og'irlashgan holda, o'ldi, boshqa muassasaga o'tkazildi ____________________________________________________________________ (davolash muassasasining nomi) qabulxonada vafot etdi, homiladorlikning 28-haftasigacha vafot etdi, homiladorlikning 28-haftasidan keyin vafot etdi, tug'ish oldidan vafot etdi, tuqqandan so'ng vafot etdi. 18. mehnat qobiliyati tiklandi, sustlashdi, vaqtincha yo'qoldi, mazkur kasallik sababli butunlay yo'qoldi, boshqa sabablarga ko'ra (chizing). 19. ekspertizaga yuborish uchun xulosa________________________________________ ____________________________________________________________________ 20. alohida belgilar____________________________________________________ 21. qabul qilinganda tekshirildi:a) qon (rw,oits va boshqa), b) axlat posevi, v)pedikulyoz) g) mavhum kasalliklar ______________________________________ davolash shifokori__________________ bo'lim mudiri____________________ f.i.o., imzo f.i.o., imzo qabulxona shifokorining yozuvi _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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____________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ kb № _____________ bemorning f.i.sh. _______________ davolovchi shifokorning f.i.sh. ________________ bo'lim___________ palata № __________ vrach tomonidan buyurilgan dori-vositalari varag'i № data shifokor tomonidan buyurilgan dori vositalari (nomi, dozasi) muolajani bajarish vaqti dori darmon va tibbiy buyum manbasi bajarilish sanasi parhez stoli № tayinlangan tekshiruvlar bajarilish sanasi davolovchi shifokor imzosi kunduzgi hamshira imzosi navbatchi hamshira imzosi bemor imzosi bajaruvchi xamshira imzosi sana ishlatiladigan materiallar bajarilish sanasi sistema yordamida v/i in'ektsiya qilish bir marotabalik shprits 10,0 bir marotabalik shprits 5,0 bir marotabalik shprits 2,0 bir marotabalik shprits 1,0 angiokat qo'lqop bemor imzosi kunduzgi hamshira imosi navbatchi hamshira imzosi harorat varaqasi kasallangan kuni kasalxonaga yotqizilgan kuni 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 tomir urishi qon bosimi haro-rati e k e k e k e k e k e k e k e k e k e k e k e …

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shzbekiston respublikasi format a–4 o'zbekiston respublikasi sog'liqni saqlash vazirligi ______________________________ muassasa nomi o'zbekiston respublikasi sog'liqni saqlash vazirining 2017 yil 25 dekabrdagi № 777-sonli buyrug'i bilan tasdiqlangan 003- raqamli tibbiy xujjat shakli bemorning tibbiy bayonnomasi № ____________ kasalxonaga yotqizilgan kun __________________________ vaqti______________ kasalxonadan chiqarilgan kun_________________________vaqti______________ __________________________bo'limi, xona №_____________________________ bo'limga_____________________________________________________________ ___________________________________________________________ o'tkazilgan ______________________________________kun yotib davolangan______________ bemorni olib yurish turlari: aravacha...

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