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Autonomy / Consent / Tort law / Anal fissure / Surgery / Blood transfusion / Ethics / Medicine / Anatomy


Med Rec. No…………………………………………………………… CONSENT FORM Surname:…………………………………………………..……………
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Document Date: 2007-10-11 23:05:52


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File Size: 206,21 KB

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MedicalCondition

chest infection / light-headedness / scar / pain / pulmonary embolus / deep vein thrombosis / heart attack / HIV / needlestick injury / infectious diseases / anal fissure / strain / high blood pressure / constipation / nausea / skin rash / heart disease / Hepatitis B / /

MedicalTreatment

physiotherapy / blood transfusion / /

Person

CONSENT FORM FOR HAEMORRHOIDECTOMY / /

Position

specialist general surgeon / Date signature Interpreter / surgeon / general surgeon / INTERPRETER / /

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