So Ha so: Mii so:

Ten: tu&iDja chi:Bao hi~mY t~: PHONG KHAM YHQC GIA DlNHE-mail:Ngay kham: I 120 DT

BVDHY Du'QC TP. HCM

Tiin su' gia dinh:Ly do kham: t~msoat : I IMSGB V/di Co Ai Ghi chukhac Tieu duong

.' CaoRA

IM~b IHA Icm IC'" IBWI

Tang lipidLaoUng thuKhae

Cac viin d~ da va hi~n co: cANHA.NVIde Co Phanloai Chi chu PARA (nii)

Timmach Tuoi e6 kinh (nu)

ne hap PAP smear (nii)

I Noi tiet Rirou/thuoc 1a

I Tieu h6a Di {mgt

Huyet hoc Di ung thu6eDaii~-u-- Suy€n

\,TMH Thuoc dieu tJi.b~nh

Co xirongkhop man tinh

Than tiet nieu sinh due Ton giao

Mat, RangHamMat Th6i quen an uong

Ngoai khoa B~ be than

Benh man tinh Vong dm FLC

Nhi€m trung APGAR score

Stress Cay Phah~

VIa. nrou/thuoc hi SCREEM

Dau man tinh Yeu t6 nguy eo

VIa.khac: sue kh6eGiai phap

XN t~m soatVide Kef qua KMm h~ cooquan: danh dh n~u binh thirimg, mo ta n€u b§t

CTM, nh6m mauthtrong.

Bau m~t co /_f Da/ /Tieu duong

H6 hap /_f Co xuang kh6p I_fRai IO<:lnlipid

Tim m~ch/ / BI,mg/j"Chuc nang gan

-.' Ni~u sinh d\lc I.J Tieu hoa / /

Chuc nang th~n-

Than kinh, tam ly /_f Vu/ /Viem gan

Xquang

Sieu am ChAn doan:ECG ICDIO ICPC2

Nuac tiel! Toa:

CT scanThu6c: _(trong_ngay)Thu6c: (trong_ngay)

X quang co quan Thu6c: (trong_ngay)Sieu am tim Thu6c: (trong_' _ngay)

N9i soi Thu5c: (trong_ngay)Thu6c:

Ferritin, uric ... (trong_ngay)BS

Ngay VaGkham: __ /__ / 20__ 1ili1 :_ Y~ll t& nguy coosU'ckhoe:

IM~ch

IHA

IGin

ICao

IBMI

IGiiii phap:

...

Dap irng diSu tri: sau thoi gian Chiin doan:Trieu chirng ICDIO ICPC2Th\fC th~

ToaKh6ng dap irng diSu tri: sau thoi gian

Than phien: Thu6c: (trong_ngay)

Thu6c: (trong_ngay)."

Thu6c: (trong_ngay)Chuyen kham chuyen khoa:

Thu6c: (trong_ngay)

Thamv~n : Thu6c: (trong_ngay)

Thu6c: (trong_ngay)

--_ .._----_. VLTL (trong_ngay) I

Ch@de?an (trong_ngay)

Khac: (trong_ngay)

--XN d~ngh]

I

,Ch~ndoan :

Kef qua

Kham chuyen khoa/_/ CTM•.nhorn rnau

Nhap vi~n -- Tieu dirong

Toa: RBi loan lipid

Clnrc nang gan

~ Chirc nang th~n

Viem ganI

~Y lOin chuye khoa: BS :

X quang

Sieu amECG I

Nuoc lieuI

·CTscan

Xquang C(Tquan

Sieu am tim

Bi~n phap duy trl sire khoe:

I

IHi kham Ngay __ I___ i20 Nguoi lam benh an: I---

I55 H6 so': rna s6

INgay ,,110kharn: __ 1___ ' 20---- laD; I

Bi~n phap duy tri su-c khoe:

".:..~.

Hi kham Ngay__ I__ 120 Ngiroi lam b~nh an:--<:- I

H8 so theo dfii b~nh man tinh

Loaibsnh :

qCH CHllNG NGl'fA

0 1 2 3 4 . 9thang 12 thang 15 thang 18 thang « 4-6 tuBi 11-12 tuBi

!'.

VGB x x x X II

I IDTC I x x x I x DtaP DW IB~i li~t I X x x ,x

,

HiB x x x x

SOi I x

1vllviR X X hay X

Thuy O?U . x x

Viem nao Nfs B xVMNnaomo

I I Ic~ux

I

CAYPHA.nt

:

I I I..

l L-I .' J-

D 0xET NGHI~lVI DI TRUYEN:

LOI KHUYEN DI TR1J):i:N:

Can thi~p Mu-c dQ t~oi gian

T§.m s6at Huyet ap M6i2 nam Tu 19 tu6i

Can nang va chi€u cao TUng giai doan Tu 19 tu6i

Cholesterol M6i 5 nam Tu 19 tu6i

NhGanh M6i 12 narn NG:,tir 40 tu6i

PAP smear M6i 1-3 nam NG:,ro 19 tu6i

KT d?c hieu cho ti@nli~t tuyen Hang nam Nam, tir 50 tu6i

Soi DTsigma " M6i 3-5 nam re 50 t1l6i

Mall ~n trong phan TUng giai doan Tu 50 tu6i

XN nuoc ti~u tung giai dean Tu 60 tuoi

Rang Hang nam Tu 19 tu6i

Thi luc/ glaucoma M6i 2-4nam Tir 40 tu6i

Vu M6i 1-4 nam cho dSn 40 tu6i re 19 tu6i

sau do hang nami

,

Ung thu (giap, mieng.da, hach .tnrc M6i 3 nam cho d~n 50 sau do ro 19 tu6i

trang (40), tien li~t (nam 50+) m6i narn

Chich ngira U6n van -bach hiu M6i 10 nam Tu 19 tu6i.....

Pneumocoque M9tlk 64tu6i

Cum Hang nam neu co chi dinh

.Tham v~n Theo tung giai dean Tu 19 tu6i

Hut thuoc, nrou, hanh vi tinh dl,lc,

phoi nhi~m HIV, dinh du6TIg,ho~t

d9ng th€ h,rc,b~o h,rcva sung, k~

ho,:!chhoa gia dinh. ch~ thLrCmg,suc ",>khoe ngh~ nghi~p

H6a dV phong Theo tirng giai do':!n Tu 19 tu6i

Folate ( nfr )

Aspirin (nam 40+)

I--.,.

Eostrogen (nG:45,+)