NUME_________________ PEDIATRU_________________________________

ORA DE DELIVERY_______________ MALE_____ FEMALE_________

V______C________EPISIOTOMY: Y / N WT:_______LBS________OZ________GRAMS

COMPLICAŢII____________________________________ APGARS:______1MIN________5MIN
___________________________________________
GESTATION:_______WKS________DAYS
G______ P_______
SÂN / BIBERON / AMBELE
ALERGII____________________
HRĂNIRE? Y / N_________________________________
SÂNGE: A O B AB + - CONSULTAȚIE ÎN LACTAȚIE: Y / N

AVEȚI NEVOIE DE RHOGAM: Y / N PIPI: Y / N CACA: Y / N

RUBEOLA: IMM / NON HEP B: Y / N

HEP B: POS / NEG TEST DE AUZ: DA / N

HIV: POS / NEG

SÂNGE: A O B AB + -
VS 0800 1200 1600
COOMBS: NEG / POS
T
PKU: Y / N
♥
VS 0800 1200 1600
T
BP
♥
RR RR

O2 LABS

______________________________________________
DURE
RE ______________________________________________
B U B B L E H E
MEDICAMENTE
0800
1200 ______________________________________________
1600 ______________________________________________
NOTE__________________________________________
_____________________________________________

MEDICAMENTE:________

ANULARE: Y / N ÎN________________

TRECEREA GAZULUI: Y / N
AFARĂ_____________

DIETĂ____________

BEBELUȘ