7/24/2019 Nota de Egreso Cuneros

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DIVISION DE PEDIATRIA

NOTA DE EGRESO

NOMBRE DEL PACIENTE_________________________________________________________

NUMERO DE AFILIACION________________________________________________________

SERVICIO QUE EGRESA AL PACIENTE____________________________________________

FECHA DE INGRESO________________FECHA DE EGRESO___________________________

MOTIVO DE EGRESO____________________________________________________________

MEJORIA: _______________________TRASLADO____________________________________

DIAGNOSTICO FINALES:________________________________________________________

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RESUMEN DE LA EVOLUCION Y EL ESTADO ACTUAL:

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MANEJO DURANTE LA ESTANCIA HOSPITALARIA:

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PLAN DE MANEJO Y

TRATAMIENTO:____________________________________________________________________

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MEDICO QUE EGRESO:

MATRICULA:____________________________ FIRMA:________________________________