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Medical emergencies / Gastrectomy / Stomach cancer / Surgery / Peritonitis / Endoscopy / Gastric bypass surgery / Diverticulitis / Medicine / Health / Digestive system surgery


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

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File Size: 237,59 KB

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IndustryTerm

food passes / food sticks / /

MedicalCondition

light-headedness / pain / cut / peritonitis / HIV / disease / needlestick injury / infectious diseases / infection / high blood pressure / dizziness / abdominal cramps / inflammation / constipation / nausea / skin rash / heart disease / Hepatitis B / /

MedicalTreatment

surgery / blood transfusion / antibiotics / /

Person

CONSENT FORM / /

Position

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

Product

PRE-OP / /

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