ࡱ > & xs bjbj$$ ; F| F| Z , / / / / / C C C 8 { $ C j x 3 % % % % -' -' -' i i i i i i i >m o i / -' -' -' -' -' i / / % % H j * * * -' / % / % i * -' i * * Z s_ % 7/v C ) \ 4 i j 0 j \ q ) q h s_ s_ F q / ` $ -' -' * -' -' -' -' -' i i * -' -' -' j -' -' -' -' q -' -' -' -' -' -' -' -' -' : & 7 . p i e l i k u m s M i n i s t r u k a b i n e t a 2 0 0 8 . g a d a 1 5 . s e p t e m b r a n o t e i k u m i e m N r . 7 4 6 ( P i e l i k u m s M K 2 2 . 0 4 . 2 0 1 4 . n o t e i k u m u N r . 2 0 6 r e d a k c i j ) O n k o l o #i s k p a c i e n t a r e #i s t r c i j a s k a r t e 1 . r s t n i e c +b a s i e s t d e F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X - F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X ( n o s a u k u m s u n k o d s r s t n i e c +b a s i e s t ~u r e #i s t r ) 2 . r s t s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X ( v r d s , u z v r d s u n i d e n t i f i k c i j a s n u m u r s 1 ) 3 . K a r t e s a i z p i l d +aa n a s d a t u m s ( d d . m m . g g g g . ) F O R M C H E C K B O X F O R M C H E C K B O X . F O R M C H E C K B O X F O R M C H E C K B O X . F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X . 4 . P a c i e n t a v r d s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5 . P a c i e n t a u z v r d s 6 . P a c i e n t a p e r s o n a s k o d s F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X - F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X 7 . P a c i e n t a d z i m u m s ( 1 v +r i e t i s ; 2 s i e v i e t e ) F O R M C H E C K B O X 8 . D e k l a r t d z +v e s v i e t a 9 . D e k l a r t s d z +v e s v i e t a s a d m i n i s t r a t +v i t e r i t o r i l s v i e n +b a s k o d s F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X 1 0 . T a u t +b a _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __________________ kods FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX 11. Datums, kad noteikta diagnoze (dd.mm.gggg.) FORMCHECKBOX FORMCHECKBOX . FORMCHECKBOX FORMCHECKBOX . FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX . 12. Diagnoze ________________________________________________________________ FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX . FORMCHECKBOX (nosaukums un kods atbilstoi SSK-102) 13. R e t s s l i m +b a s n o s a u k u m s u n k o d s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X ( n o s a u k u m s u n o r f n a i s k o d s a t b i l s t o ai O r p h a n e t r e t o s l i m +b u k l a s i f i k c i j a i ) 1 4 . A u d z j a l o k a l i z c i j a p r a o r g n i e m , a n a t o m i s k m d a <m ( 1 l a b p u s e ; 2 k r e i s p u s e ; 3 a b p u s j s ; 4 n e z i n m s ) F O R M C H E C K B O X 1 5 . D i a g n o z e a t k l t a ( 1 v r ao t i e s p i e r s t a a r s kd z +b m ; 2 p r o f i l a k t i s k a j a p s k a t ; 3 s k r +n i n g ; 4 k l +n i s k i n e a t l i e k a m s s t v o k l i s ; 5 p c n v e s , b e z a u t o p s i j a s ; 6 a u t o p s i j ) F O R M C H E C K B O X 1 6 . D i a g n o z e p a m a t o t a ( a i z p i l d a , j a d i a g n o z e n a v m o r f o l o #i s k i a p s t i p r i n t a ) ( 1 k l +n i s k i ; 2 r e n t g e n o l o #i s k i ; 3 u l t r a s o n o s k o p i s k i ; 4 m a m o g r f i s k i ; 5 k o m p j kt e r t o m o g r f i s k i ; 6 a r m a g n t i s k s r e z o n a n s e s i z m e k l j u m u ; 7 e n d o s k o p i s k i ; 8 r a d i o i z o t o p i s k i ; 9 d i a g n o s t i s k a o p e r c i j a ) F O R M C H E C K B O X 1 7 . D i a g n o z e a p s t i p r i n t a ( 1 h i s t o l o #i s k i ; 2 c i t o l o #i s k i ) F O R M C H E C K B O X 1 8 . A u d z j a m o r f o l o #i j a _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ M F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X / F O R M C H E C K B O X ( a u d z j a m o r f o l o #i j a u n k o d s a t b i l s t o ai S S K - 1 0 2 ) 1 9 . R i s k a f a k t o r i ( i e s p j a m i v a i r k i a t b i l ~u v a r i a n t i ) ( 1 s m 7aa n a ; 2 a l k o h o l s ; 3 s t a r o j u m s 3 ; 4 7+m i s k s v i e l a s ; 5 p r m a n t o t +b a ; 6 i e d z i m t s s i n d r o m s , k a s p r e d i s p o n ; 7 c i t o s t a t i s k a r s t aa n a ) F O R M C H E C K B O X F O R M C H E C K B O X F O R M C H E C K B O X 2 0 . V l +n s d i a g n o s t i k a s i e m e s l i : < : F T V Z \ ȼ|pg_PE h*F hHm CJ aJ j h*F h,Z CJ UaJ hHm CJ aJ hHm >*CJ aJ h hHm >*CJ aJ hHm 5CJ aJ hQp hHm 5CJ aJ hxW hHm CJ aJ hQp hHm CJ aJ h? hHm aJ h|+ h