bilet de iesire din spital
Post on 17-Oct-2015
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Judeul
Localitatea __________
Data ntocmirii20_luna__ziua__
Unitatea sanitara_________________BILET DE IEIRE DIN SPITALBolnavul: numele_______________ prenumele __________________Sexul M / F n vrst de _________ ani, cu domiciliuln: judeul _____________ localitatea _________________________str. _______________________________________nr. ______________Dispensar medical _________________________________________A fost internat n secia _____________________________________cu diagnosticul: ___________________________________________________________________________________________________
de la _______________________pn la ______________________i iese n stare _____________________________________________ESTE/ NU ESTE purttor de germeni: felul ______________________
tipul _________________________
REZUMATUL FOII DE OBSERVAIE (epicriz, indicaii)
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