最新内科英文病历模板.doc

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1、__________________________________________________HUAZHONGUNIVERSITYOFSCIENCEANDTECHNOLOGYTONGJIMEDICALCOLLEGEACCESSORYTONGJIHOSPITALHospitalizationRecordsforNone-operationDivisionDivision:__________Ward:__________Bed:_________CaseNo.___________Name:______________S

2、ex:__________Age:___________Nation:___________BirthPlace:________________________________MaritalStatus:____________Work-organization&Occupation:_______________________________________LivingAddress&Tel:_________________________________________________Dateofadmission

3、:_______Dateofhistorytaken:_______Informant:__________ChiefComplaint:___________________________________________________HistoryofPresentIllness:_________________________________________________________________________________________________________________________

4、_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5、_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

6、_______________________________________________________________________________________________________________________________________________________________________________收集于网络，如有侵权请联系管理员删除__________________________________________________PastHistory:GeneralHea

7、lthStatus:1.good2.moderate3.poorDiseasehistory:(ifany,pleasewritedownthedateofonset,briefdiagnosticandtherapeuticcourse,andtheresults.)Respiratorysystem:1.None2.Repeatedpharyngealpain3.chroniccough4.expectoration:5.Hemoptysis6.asthma7.dyspnea8.chestpain____________

8、___________________________________________________Circulatorysystem:1.None2.Palpitation3.exertionaldyspnea4..cyanosis5.hemoptysis6.Edemaoflowere