İÇİNDEKİLER

312 Çalişma
ve
Sosyal Politika
Bakanliği
2.2 �imdiki hastal�klar, yaralanmalar, zararlar (hastal���n durumu hakk�nda k�sa durum tahkik verileri):
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III. STATUS PRAESENS:
3.1 Ya��_________. Boyu__________, A��rl��� __________, BMI: ________ (kg/boyu metre 2 )
(doldurulmas� mecburidir)
Hareketlilik _________________________________________________________________________________
Yönlendirme/uyum:
�) mekan: __________________________________________________________________________________
�) zaman: ____________________________________________________________________________________
�) ki�ilere:
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S�STEMLERE GÖRE STATÜ:
3.2 Kafa ve ense: ___________________________________________________________________________
3.2.1 Duyular: göz, kulak (i�aretleyin):
Görme azalmas�: 1) YOKTUR 2) VARDIR ve azalma ne çe�ittir:
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��itme azalmas�: 1) YOKTUR 2)VARDIR ve azalma ne çe�ittir:
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3.2.2 Vestibular sendromu : 1) YOKTUR 2) VARDIR – telafi edilecek ba� dönmesi
3) VARDIR - daimi özellikten telafi edilmeyecek Vestibular sendromu
3.3 Gö�üs kafesi: ___________________________________________________________________________
3.3.1 Ak ci�erler: __________________________________________________________________________
3.3.2 Kalp: ________________________________ tansiyon: _____________ nab�z: ________________
3.4 Kar�n:__________________________________________________________________________________
3.5 Ürogenital/idrar yollar� sistemi:
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3.6. Lokomotor/hareket sistemi:
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4. Nevrolojik ke�if (Mütehass�s taraf�ndan ke�if tan�mlan�yor):
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5. Psikolojik ve psikiyatrik ke�if (Mütehass�s taraf�ndan ke�if tan�mlan�yor):
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