Samenvatting TGV Formulier Schouder

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Samenvatting TGV Formulier Schouder

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TGV Formulier Schouder

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TGV Formulier Schouder

AANVRAAGFORMULIER AFD. RADIOLOGIE
ZIEKENHUIS MBRT

Bijdorplaan 15 Naam en handtekening aanvragend
2015 CE Haarlem specialist/huisarts:
Tel. (023)5412812 Dr. Van Zonderen
Afd. Radiologie (tst 200) Afdeling Chirurgie
Specialist : Dr. L. Kast

Patientnummer: 7687568 Adres: Copernicuslaan 112
Naam: H. Newton m/v 2112 HH Santpoort
Geboren: 20-12-1965

GEWENST ONDERZOEK : Schouder L

Medische gegevens bij aanvraag:
Aanhoudende pijn Li schouder, bewegingsbeperking.
Concrete vraagstelling : PHS?

Mobiliteit patiënt : X lopend X kan staan
O rolstoel
O bed O kan niet staan

AANVRAAGFORMULIER AFD. RADIOLOGIE
ZIEKENHUIS MBRT

Bijdorplaan 15 Naam en handtekening aanvragend
2015 CE Haarlem specialist/huisarts:
Tel. (023)5412812 Dr. Van Wonderen
Afd. Radiologie (tst 200) Afdeling EHBO
Specialist : Dr. L. Kast

Patientnummer: 7687568 Adres: Newtonstraat 7b
Naam: G. H. Pascal v 2342 HH Overveen
Geboren: 20-7-1939

GEWENST ONDERZOEK : Schouder R

Medische gegevens bij aanvraag:
Gevallen op straat.
Concrete vraagstelling : subcapitale humerus #?

Mobiliteit patiënt : O lopend X kan staan (even)
X rolstoel
O bed O kan niet staan

Informatie Aanvraag

Gewenst Onderzoek: x-ray schouder
Zie aanvraag

Medische gegevens: Gevallen op straat./ Aanhoudende pijn Li schouder,
Zie aanvraag + verklaring bewegingsbeperking.
betekenis

Document information

Study: MBRT
Uploaded on: February 3, 2024
Number of pages: 4
Written in: 2019/2020
Type: Summary

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