Субъективное обследование

Жалобы: __________________________________________________________________

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Анамнез заболевания: ______________________________________________________

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Анамнез жизни:

Семейный анамнез и сведения о наследственности: _____________________________

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Диетический анамнез и привычные интоксикации: ______________________________

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Курит ________________________________, не курит ___________________________

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Алкоголь – (не) употребляет _________________________________________________

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Гинекологический анамнез: __________________________________________________

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Перенесенные заболевания, операции, травмы __________________________________

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Болезнь Боткина – не болел, перенес в _________________________________________

Туберкулезом – не болел, перенес в ___________________________________________

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Аллергологический анамнез _________________________________________________

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Санитарно-эпидемиологический анамнез ______________________________________

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Профессиональный анамнез _________________________________________________

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