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A Anamnese Adulto

Por:   •  13/8/2019  •  Artigo  •  338 Palavras (2 Páginas)  •  9 Visualizações

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Data do atendimento: ____________________________________________________

Identificação:

Nome:___________________________________________________________________

Idade: __________Sexo: _________________ Nacionalidade: ______________________

Estado Civil: ____________________ Data de nasc.:______________________________

Grau de instrução:__________________________________________________________

Profissão:________________________________________________________________

Residência (cidade/estado): __________________________________________________

Telefones para contado: _____________________________________________________

Atendimento:

Frequencia:___________________________ Data/hora:___________________________

Queixa Principal:

_______________________________________________________________________________________________________________________________________________________________________________________________________________________

Secundária:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

Sintomas:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Histórico da Doença Atual:

Início da patologia:

________________________________________________________________________________________________________________________________________________________________________________________________________________________

Frequência:_______________________________________________________________________________________________________________________________________

Intensidade:______________________________________________________________

Tratamentos anteriores: ____________________________________________________

_______________________________________________________________________________________________________________________________________________________________________________________________________________________

Medicamentos:____________________________________________________________

Histórico Pessoal:        

Infância:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Rotina___________________________________________________________________________________________________________________________________________________________________________________________________________________

Vícios:___________________________________________________________________________________________________________________________________________

Hobbies:_________________________________________________________________________________________________________________________________________

Trabalho:_________________________________________________________________________________________________________________________________________

Historico Familiar:

Pais:____________________________________________________________________________________________________________________________________________________________________________________________________________________

Irmaos:_________________________________________________________________________________________________________________________________________________________________________________________________________________

Conjugue:_______________________________________________________________________________________________________________________________________________________________________________________________________________

Filhos:___________________________________________________________________________________________________________________________________________

...

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