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Abscess / Anorectal abscess / Surgical procedures / Anal fistula / Fistula / Surgery / Incision and drainage / Diverticulitis / Tooth abscess / Medicine / General surgery / Proctology


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

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File Size: 216,47 KB

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MedicalCondition

fever / cut / perianal abscess / needlestick/sharps injury / HIV / disease / OF PERIANAL ABSCESS DOB / pus / infection / chills / high blood pressure / constipation / nausea / skin rash / heart disease / lightheadedness / abscess / disorders / opening an abscess / /

MedicalTreatment

incision / catheter / surgery / drainage / /

Person

CONSENT FORM / /

Position

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

Product

Under / /

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