Roteiro de anamnese
Por: raissalore • 15/4/2015 • Trabalho acadêmico • 464 Palavras (2 Páginas) • 1.209 Visualizações
CENTRO UNIVERSITÁRIO[pic 1]
INSTITUTO DE EDUCAÇÃO SUPERIOR DE BRASÍLIA – IESB
Docente: Cristina Brolhan Turno: Noturno
Discente: Raissa Lorena Matrícula: 13211120104
Roteiro de Anamnese
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:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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