1

on General Hospita
.__1__
F. Tanedo Street, Poblacion, Tarlac City

CLINICAL COVER SHEET

Personal Data ··•·•·• 'ADMej ~~ ~~P : : : .

Name TAGARA, ,RQMME,h DE GUZMAN Hospital No. 00644717
Address PRK 2, Manaois, PANIQUI , TARLAC Pat. No.I Case No: IP18-001383 I 18-01346
Birthday February 19, 1979 RoomlBedlType : ICU1311CU - Php1,600.00
Age 39Y3M9D How Adm itted Emergency Room
Sex Male PhilHealth NON PHIC- i~v-J U\i'\~
Civil Status : Married Religion CATHOLIC 0
Birth Place : Nationality FILIPINO
Spouse Occupation
Father Tel. No.

L. . ~~t~ CORAZON TAGARA Insurance

••• •• •••••OOoUoO O••••OOoOO•••• •• • • • ••••000000
I
0•

:t::t::~l~1v.201e
1 Admission Time : 08:45AM
01~;~~0;;~
Discharge Time :
19 [" 11 <( ···
4 : c.fO f""'
f\g"~~fci::;6::□ ~; D;~~ ·\
0 SM O PRM□ SD O PRDO IMIDO IM \
1 Admitted by : M .N. ACIERTO Discharge by : 0J \ \
! Admitting Nurse:
·....... ----·-·. ········································ ············--·······-·························-······························· ········••··· ..
.....\. "i.~!~......~ .~.~~. ~.~~~~.~~··· . P. Old Pati~nt .\

_Notify .In .Case .Of.Emergency. ..................... ................................. ~.!.~~t~.i.~~.'.. ~.~~.~~~.~i.~ s:1.. ~.~~.9~':'~~~. ..... ................... ..........,
1 Name CORAZON TAGARA Allergy
/ Relationship: MOTHER Precaution :
l Contact No : 0918-5082067 Med A lert :
! Smoker : No No. of Days:
Addre~ ·A,im.itiing.Phy.sician························· · · · .....·.· . . . . . . .-.:· .:. ·.:
i:~;~rre~;~ ·
1 =- ---·································· ················ .......... ················ ·· ·· ··

- ; : :. Data~. ······ ·· -- · ·· · ·· · · · ·BARBA:LEO FLoREs M.D.

[ ~-...-..... ,-,;....---······················"•·"•'··•··············· ·-···· ..... ... ...... ········· .............. ·············· Social· Service Classification
·· · · ······ ········ ....... \· oc1 Oc2 0C3 oo
~
\CD Code
.I~ I~
1. 1£ I 1
l £fq.'I
j 11.q
2.

3.

RVS Code
1.

2
 Pa.tient: "]oyC;fU , (\faMuJ Sex: M Age: J l 1 Civil Status: ¼',Ai,M t-~

Address: \ ~U. \'1U\l'- ~vlV\,au,· ] ~lv'l\.. DateAdmitted: odL6//-c Time: 6.-w,

Attending Physician: \t\,.
'
,j U Date Discharged: k("((q Time: 4~ £fV r
CHIEF COMPLAINT: "'- "' - L, "-"" \ --<->-- J__,. "'-- 1 1J f ~ 1 ~
IDSTORY OF PRESENT ILLNESS: '{ '\:' ~"' cS) ~_ '\---t ~<r, l, "-"" ✓
°'"> ""' -
& rr ~ ~[l 9 ~- -r ~ __._ J,L lv,v,, I n c.__-'-'-' \ , I (} r !L.
RELEVANTPASTPij~NALHIS..TORY: I (: J .
_ C" l ./~~"-& ~
(f
J._ ~)l -v- .
PERTINENT PHYSICAL FIND as: r . nL u . . \ . . ~t _._,__
~...._.._\(' L (l~C\ ~ (\<' \ ( (l 1 2
PERTINENT LABORATORY RESULTS: () l Q Cr.
Ii. ""(lp ,
\J
\ ~ . Q; -
\ "
'--( {. \ -
N-- -
'-
(:_ j,, o...,-.9 ('I C' e> 6 ~ l, l - l,.,t"l.tr ~ ?\:J'S ----k -., -'-"I
. ._ \ ~ et'--C QD'-·,.\' '"'-( ~ "" µ '\

DIAGNOSIS: C (,,. U) . J cf) ),_L __;()~\I'

. ,i-- ~
MEQI~AT!ON: '
Q ~"'k 1- ~v
l {., ·-
J'19P
\"O V"-~ ""~ L { (o~
l lr 'p ~?
(>c:_ ul tr0J'-'
s}
c-,/I f
~)U-Y'J
.
\
LL.-
.
c~~i"t-IN~ wA~h-\~.; Q l CLJ .· f ,_, ~ --9. r [nli , h4 o9J
c1'i'il; t ~ r1--jf~~ ~ ~ ~ r,;,-~ "'d w Vf\ - ' ~\ -
0

...,,
OPERATION PE&frORMED: ls--P
IDSTOPATHOLOGICAL REPORT: ~ --..o

CONDITION ON DISCHARGE/ TRANSFER: t ._. ~~

REMARKS:

M.D.
'
A ending Physician
Lie. No.: 1-.-+----
PTR No.: .L--.----l.__--
TIN No.: _ _ _ _ __
 TALON ENTERPRISES AND MANAGEMENT, INC.
TJ.11..8N GENERAL HOSPITAL
F. Tai\tdo St., Tarlac City
Tel Nos. 982..0239; 982-1400, 982-5415 to 16
CLINICAL HISTORY

,~
Date
---i
ROOM: BED NO.
~ 1tAll\O,X"' ~\)•rnii
I _ _j
I

Al IENDD~G PI~SICIAN AGE ' ,·. SEX V\

~-" $~- I 3ctJi •'" ·
CHIEF COMPLAINTS:
)J;,-,-h,,oYS) 1l/d"~7J
(Pc;LJ.;} /4) .
IDSTORY OF PRESENT ILLNESS : fra,.,,iitt ~ f. s ·ItA a5

~d~J ·~ ~·
PAST IDSTORY:

PERSONAL AND OB-GYNE HISTORY: (f) ~~

{rJ af)c~ ~~

REVIEW OF SYSTEM C'/? ,,,./ c,...f-vJ> J ,(!}

{v ~/:2.,.,JS S
(,-tAsthrna
( .-,Diabetes
FAMILY HISTORY ( ,,-rMypertension
( H{eart Disease
( ) Others ~ - - - -
(..-,Tuberculo~is
( <fcancer
 TALON ENTERPRISES AN O MANAGEMENT, INC.
TAutN GENERAL BMPITAL
F. Ta lledo St., Tarin Cit y
T.t No., . 9112--0239: 911l-1400, 982-5415 to 16
PHYSICAL EXAMINATION

I NAME OF_P _AT

_ I_ENT
_:_ 11
f).Ci<>,"l'O \
fl .
'U\l''Y' lJ\
~-:--z.=::-=-::::::::--- ·--1._______.:___----:;,k::::=-..::~ -
AITENDING PHYSICIAN:
J___ \".__ _ _l~-
__!__' J
t, - - - _ _ j
I ~ ONSCIOUS HERENI t,-IN DISTRE SS
I BP \ltO /(-(V PR \W RR l't TEMP. ); \' 0 c WT _ _ _ Kg.
ISKIN ) WARM r--- ( ,)-MOIST r . (~ D SKIN TURGOR
IHEAD -EYES ~ c---:~ ' SCLERA ~ PALPEBRAL .
/ E ARS ' ( CONJUNCTIVA \
I NO SE (<")NASOAURAL DISCHARGE
\
IM OUTH { )JPNSil..LOPHARYNGEAL CONGESTION
/ TI-IROAT
I NECK
M SUPPLE
( )CERVICOLYMPHADENOPATIIY
( ) MASSES
\
I
/
LYMPH NODES
, CHEST
L UNGS
/ BREAST
(
~

( \fsYMMETRICAL CHEST EXPANSION

~BREAlHSOUNDS (.+WHEEZES
( r}RETRACTION
K)CRAC~ES \
,. HEART (<JADYNAMIC PRECORDIUM ~RATE /~ YTHM ( ')NlURMUR \
\
(~EQUALPULS_)!S
BLOOD VESSEL
~ ~ O W E L SOUNDS \)TENDERNESS
\
ABDOMEN ..--·
( ) ORGANOMEGALY
RECTAL
GENITALIA
BONES - JOINTS
MUSCLE
EXTREMITIES (~NORMAL
\
NEUROLOGICAL ( ) DEFICITS \
EVALUATION AND IMPRESSION :
\

- --~-- -----
•
Lie. No_:_ _ __ __ --
PTR No.
 RPRISES AND MANAGEMENT, INC.

TALON GENERAL HOSPITAL

F. Taf\edo St., Tartac City

GRAPHIC AND INTAKE AND OUTPUT RECORDS

,,,,,- /
-7 (.,.: ...._
{ £(V I) i ( I ./
DATE
HOUR A.M. P.M. . A.M. P.M. A.M. P.M. AM. P.M. A M. P.M.
4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12

...
41 ...
40
""
IC!

...~ 39 ,()2

...
I 38

G}-;
"" ,r
-"-Y
. v -r ,
v:.. ~ /'-, l
~
\ I
.,
.
- .,, . - ,,.,,
.
,~.
'
~·. "
- ,,,I
l) D I,__,.- l,A' 1/ I ;.v
....... ..._
- I'! /1 / ' j["\ )
' '
~-
/

,~ I~ l' '
.,
.
-r-r ~ .'.-:-;:"
t~
I-Ji pv
~ lltl u,O
,
f ~

- 1tu I
'1vv ,, J ~ -
II\"
, -::
)b~
<.m-----
I,,
I /U'J
/"' V
,;, \Cl'
1J'0

il \) /MJ
-
1w
--- V I
36 J,;-.. ,,,_ \'~v
ll"
/1,
Iv- I
r
35 /; ( I)

,.
100
1u
,.
-
""'
I\
.

•"'
✓
,c

\
[\ _,, / '
__.,
I
""' r--. -1 \
r
\
-Y
»J uo

i '---
-
,,.✓
~
"" '----
V ~ I V
I "
80

-
V

x
A. V
~

"\
D .... v- '.-I
.
71)

..,
RESPIRATIONS 1i ~ ],? 1, ],, '7 2.'l. I'.\ V, ~
,., JD1. 1, U !~ 7/( ? (! )0 }\) ?--'L 1.AI T)_ I~ 11 1,'f uV H J""f \',{ 'H
HEIGHTiWEIGHT
/ / / l ·/ 1/
DIET
I Tv,>E

I GFP
I I I I I I
TIMEIHTERVALS I 7-3 I 3-11 I 11-7 I 7-3 I 3-11 I 11-7 I 7-3 I 3-1 1 I 11-7 I 7-3 I 3-11 I 11 -7 I 7-3 I 3-1 1 I 11-7
cw () 'Ill I 7(J)
-
PAREHTERAL LjU) a\7> 10"74 &Y I fll(,q &:ri l.()lb
if l101/
i
~
OftAL.OllrueE-

•HRTOTAL
l~u
~S°"t)
~--;> -
4'{{
ltv
I 1<./.1
)'[1)
PlCT>
i~'D '2.-lt>
Il;J0
&C/11
/OD
r; tj,; 101
vi
T2.\
,j i) O~l
$: l '1
l'-'"-
~Ii
tojo :Ju O 1. IJ!if o I1S9-/- ' 3') :.fI'.! 7GC Vetl
- '
:UHRTOTAL.
....
URINE .
'b~"D 4 yt,.,!.,,,1 9~ 'l ~ lU 00DU- 11J l'J iiWo /v"l)-v ~'1;1)
I 1-tlV I l,~""i) 4\Y\) WJ 'tl,r'/) l 0-
...
. ~ 01l4ER
SUCT>OH
-- /4' .. ,.,.,.,. \ t 1AA1"' / i-l J~~!.
I

ll liRTOTAL <µ-Yi)
"Jt;b ,~\)'() tlJ i) (J \l)b'V
!4W 1'fi"efv yvv I, '2-( o {\; 6') 4cr\ ~.n) ,'.51Fu ' I

2,41-fRfOTAL.
,t-z.,~ J J.-
c,.,,-#),-

STOOL
0 6 u -" ,ID. . '\
() 0 (J 0 1) u D 0 r
V I
}

[__f _O_t...,
lo_l't-1__,~ _rw_1Y1_u_\ _ _ _ _ _ _ Jr
 "fJt\LO~ GE~ERli\L Y~OSIP&'U}\ll. '
r1• Tail'k,d() nt, ·r1.u1~c! CKi,

(,ln:APlilC ANl> INT AKli: /,\1\IO OlJ'f!J'U n· !~UC;iGO!F!rni

;-;i :i!ivi:'- ---'@r=~ --·--<1·!.=-~~-~-- ~:~.:~:-~-=~- "~::~-~:~--=-. - - - ---·-r;r~------------ ·: -~~ -~~~:= ;•-:=:___-._~-.-:~ ~~- _____
1
~ f·_-~~~--~~~-:~
_1_«;>1.!R_,_ _ _.... __ --- ~ '~]-.__ _____ ~'.~: ---· _____ I\IIH_. ________ P.f\!l ..___ ___l~_.NI, ___ _____ F\ 11~.~- __ ,, ___ J\,tV!.____ .... P~~-------- ~ -~n ... _ __ f '.:.~ .- __ _

4'f
~I/)

•~-
3ili

I
~-
33

it'>---
'----
~
~5
,-.---------■ "Au:1111
..,,. Ll:1111:IIAL HU!iPITAL
TARLACCITY

·s ORAL MEDI<-:A TION SHEET

ORALMEDS.

\ \,,~ TW t •~
 TALON ENTERPRISES AND MANAGEMENT, INC.

TALON GENERAL HOSPITAL

TARLAC CITY
MEDICATION SHEET

MEDTCA TJONS
AND DOSE 0

------ ---
0- :..=-------
----~-
- -------~----
--·---
---;:.--- .

---
 TARLAC CITY

ORAL MEDICATION SHEET

-----,---,----,i!!0j~----,---~--
_ _ _ _MED_ANl)_1_c_~_1~-;_ ~._.,v._____.(b
s __________.__ _
0"'---..i....-(0
;;;..___..__(D
.;i.;....,.
;.
ORAL MEDS. ;

--------·-
r
 C@ I ~
MEDICATlONS
AND DOSE
I \
PRN ORAL MEDS.
I_ Citi_}'v'_,<L_' \i_e-- ---...:7:..( . __:_
.:::.. .~ ~ ;--_.:h_~\o _ _ L 11/~Wl y\ 0
--c, _J__ >. \,, r:
-C\_ ~ {h'f t
K.9t> / 1D

\
\
\ \ \
\ \ \
\ \ \
I \ \ \,
\ \ \
\ \ \
\\ \\ .
.STATORALMEDS. (-rt) 1 C:EJ \ G \
\ \ \
\ \ \
V ,: \
_\ C --(-( \ \
\\:'I. \
'~~
\
\ \ .
\
\ - \

\ \
\ \
\ .\ •.•
..

..
., .. \
-
\
- -- .· '
\

l
~---
1
t
~ ' ,le"'
 TALON &ENERAI- .-u,r-• •-•-
- T ARLAC CITY
JV MEDICATION SHEET

MEDICATIONS
1.---AND-OO-SE_ _ _ _
I
1 ........
\ ~~--Tl-------------.i.---
G?.......--------l ~ I
·PARENTERAL MEDS.

I
I

i
I
:l --- -- 1 - - - - - +- - - - - l l___
- - - - - -- -- -+--- - - ·-' r - -t - -- +- - - J__ I

- - - -- -- - -+----~

------

~==~=-=-=-=-=-=-=-=-==-t~--==-=-==-~t=-=-=~-~~~-1~~====-=t'==-=-==t-_----
---_-__-_~~~-~~~~-_-11t1-=-- -=- - =- =_L---~-----t--
- =i - - -_
-- •- -- - - - - ~~-
!
\
-- \- I
I
I
 ,, .
ENTERPRISES AND MANAGEMENT;INC. .
TALON
TA1 ON &ENERAL HOSPITAL
TARLAC CITY
WMEDICATIQNSHEET
 TALON ENfERPR.1SEs AND MANAGEMENT, INC.
'I'AI.QI\I lil:ftiER.4U. IIOSp,r-41.
TARLACCITY
MEt>rcA TIONs
~•lCAT-lQNs,ree_z
[; ANDoosE
G)

\
\ ____ _
-----t- ~
\
L - --
-I -
- · -
- -
'l
,'Ji"
/

I
1 i
I
--r
j _ _
I
-i--
1

I_____
I
-- r

/ .
 TALON GENERAL HOSPITAL
F. Taflcdo St. Tarlac City

INTRA VENOUS THERAPY RECORD

Name :
-T~@ ::i½fflffii\ kn·>e /-{f"-t"-/~Age: ~Room:__,_c~_1 _ _ _ Doctor: D< · V.C'L. _ __

I I I
-- I I
DATE NO. SOLUTION AMOUNT RATE
TIME TIME TIME
ADDITl'VES . STARTED
DUE CONSUMED
~ 1 ~N4>
- fl. 1v #u
2 ~ - !:0 VJ
-· ,_s_:°-t.
3
4
~,
1L
¾-h_ .
-5jh --·~----- 11,

)., r-
), /V- ]t)'< rv-
O'f:q;'

5 tvN~1
IL___ -~~~ :t(Jo'I 11 . t
IL
6 vt t
HJ I 11 :_1,o tnc ic:_
l·L :vi . .h.,, .,.,..
/ tfl'.. tl. S"-tM_
7 J,,l I~
~l) J" Am, tt~
8 L,
9
~-
tv
10 IL-
___k\ 11
12
DrtYn L, u

BLOOD TRANSFUSION RECORD

------~---_::;::.:..:=r--r ~ - l ~T~IME~i-:;T~IME;;•r1~T~IME;;~,-
Co:::;>~NT AMOUNT RATE I .,S.JLfERIA.~:.:L::~N.:_:0:.:_•.1..:.ST.:.AR
~-T-E_D-L--D-U_E_ _c_o_N_s_u_ME_D
~=J=A:,=TE==;=N=O=.
1
~==========*=======~=====~r=========rr=~--,--i•=====:=
2
 . '

TALON GENERAL HOSPITAL

F. Tafledo St. Tarlac City

INTRA VENOUS THERAPY RECORD

Name: ~~ IL.A t~,7:U 4 ~-.r---1R
Age:-11._Room: lr...NJ Doctor: JS;\

= co~J
------
DATE NO. SOLUTION
AMOUNT RATE ADDITIVES ST~D

_VJ,~ - iV,

'
1
2
D.r tJ
rn-vJ
qo cc,

'7t/J lL
f -ll) \o[

r✓iv-x lh-
~
i /il "'j
f,.) , et-rcii ~"

f- tv~ t'\ 7..d. f·,;

'

(,
(,' ") Oy wv

(.;( /''
-
Yp
9 ~)j[J,11. ""'
.f.•t1(p
-
-1' /VJ 3 {)rw q~k T- Jo i..J ~
~, 1/1
t lV'v\ Nr~ ,C- -P f-p ~ ,(£ /1' l\ ;ll F
4 ,j
~II ~\>
.
5
.t\1,...

C:~
If If l£,,
'fo C(.,,
r;
1'
l"'>- h
"'v½\rn:
I- IN-;_ \J'JU~ ·~" t1 : If () ('\..
>; '. Ir /;,'(Y'-
- ~ ~ro j.,-
q(.,/Vy./
I

, , l'~/-JL~ JV'
Cfvi'u
:rhtt
6
7
l) rv0
\i) ,:n,::i
I
/:'/.ow
c,.2i:,,. ,
10 - "IN\,1/\1,1
/b--1,,.') ,,n \~ t
V
j (ti 1'\lw lv)'£MXA.!-J"
ID !Nv,. )\) {1,,,.{;1 I
'{fyvyv

/'.-1Dp,ti
-·- J;~
) . 7u

~ 1,1
? .?,,1} 8 fl~ q ;/fV-_. bD - ,M/1~ t-~~fi-1 tlv\ - 1 .- "~6p,---
(
I
I
9 ~tiJ q)r0-- ~'t11 l.i- ~ " :J , .
II"'
- vtf. '13tJrr' /Dw}i
,r-/ 1_i I 10 'lbv qv ec iv - 'JD~ fl? +- lJ~ tl)~ ~ /!V c,vVJ
I.I

Z/ :1 o/{)v'
1r/l1 11 0h,c, p-~tli-, H-t1rx fJt ur-&·ff}t1 ~ :Jll ,OM_ - V

.~
G)~
J

12
- q/Y)
~

S- , 'JI V
hr~~ lijD C(... [ill ~} u wrll<i -+ltl~ IVu•r.~,, .,,)~ /1):p l l\.;
J

BLOOD TRANSFUSION RECORD

I DATE INO. / co=~NT IAMOUNT I RATE I sE~No. /sT~o ·~ TIME

CONSUMED

1 \
2 \
·3 I
I
I

4
s I

)Ill Afl ti Pl~ E Of{I f ;

 TALON GENERAL HOSPITA_L
F. Taftedo St. Tarlac City

INTRA
()t~J VENOUS THERAPY RECORD
__}_2, (, --.r-;o
me: - . ~ f71 , / ,,0- <>
- -t--~
,Tr-__:_- ~ ~ ~ - - - - - -Age:~Room: f~ Doctor: <. Ji;!-
)ATE NO. SOLUTION AMOUNT TIME TIME TIME 7
RATE ADDITIVES STARTED DUE CONSUME~

LJ/ Ii 1J »~ czru..-- fJ -~ft t1.'o Munip..:i

t.,l,o. !tt O , 't✓ "lo c:v \o - u ~"'ll'h l \O ,V1.q N14\~1 r:re
J1o,M
I
/L_.,...,,;._,·
. I v v-ynv
4,rwv
q ..,f opm
tlt)Vu\
3
4
5
I 6
I 7
8
I
9
I

'
i 10
11
12

BLOOD TRANSFUSION RECORD

DATE I NO.

1
co:::'r:~ I AMoUNT I RATE ISERIAL No. / sr~n ·= TIME
CONSUMED

2
3
4
5
 TALON G.£1'f.._,~_LJ ._.__ ..., _
F. Taftedo St. Tarlac City

INTRA VENOUS THERAPY RECORD

Name: ~
~~ ~~~
. rf 7P"
h,1, -.r-tll
~ a(" ?I , "1"~~..b!=:.J.{ Age: Jq Room:._ !0
_;_ _·1./_ _ _ _ _
'
Js_4_ _ __
poctor:_ _

11ME 'ITME TIME

DATE NO. SOLUTION AMOUNT RATE ADDITIVES STARTED DUE CONSUME

y
'..s-- ..1;) lb J Dr\'1 i ell cL ] y 0 -+ I0 ~ -Arn1·id.c,i '1>v \{ '-/ : yo P'7l 1 <ft, /J ,.,, 1"p ""-- -
I c;·,, r, 1 t () ' r; . 3 ,>r rr /,{ · 3 J ii/(
! s-- · j l - IS 2 h.r 1•1i r .1Pl"'' 0 / rr (.) d.w, I /2- 1'M
I I 3
I
4 I

s
i 6
I
7
8
' 9
10 I
11 I
I
12 I
i

BLOOD TRANSFUSION RECORD

DATE / No. / co=r:NT I AMOUNT I RATE I sERJALNo. / sT~D

'IIME
DUE
TIMI
CONSUl\

1 I :I
2
3
I
! 4
J 5
I
 -!lie" USPIT A I . - •••.., ..l\'l,~t::NT. INC. . . ..
I J\L~
O~l\1 6EN ERAL HOSPITAL
TARLAc CITY
00cTOR•s ORDERS
DATE
L'AIL Y PROGRESS REPORT

, ,/.h -~ 1 ~ d,_ /4,

'7 £<.,._ . ✓ <'.26 o4, S' ' to

) / / /2- 7 3/ .-
 TALON ENTERPRISES & MANAGEMENT, INC .
...J\Lol\l liEI\IEflAL HospnAL

--------I:-'. --,_______________
DAT

\ 1"2i\t'6
c DOCTOR'S ORDERS
TARLAC CITY

1 ·- DATE I DAILY PROGRESS REPORT

l CT
h''{\ "'7

' ·y o

r1r11tt1t

L
-,~ '!:
. ~.;t .

-
 • J , •

TALON ENTERPRISES & MANAGEMENT, INC, .

TALON liEI\IERAL HO!iPITAL
TARLAC CITY

DATE DOCTOR' S ORDERS DATE DAILY PROGRESS REPORT

/IA ~ I f<:..-- ~~
fa'- t _p.,_ t,) ~"'-<

0 ~
i ~ , {. 't ~-
~ ~

~:6 { ~ '~1) 6 .
tff' .f.J ~ L---- l(__ I i, v o<
\l' (0 .-...