For a more accurate assessment of the health of the child, try to fill in most of the below Patient Form.


Informatii pacient

Pacient name:
Date of birth: Sexul: M F
Weight at birth: grams Current weight: Kg
Length at birth: cm Current length: cm
Head circumference at birth: cm

Antecedente pacient

Family history that may be relevant to the current issue:
Ante-natal history (any known developmental anomaly discovered in the period before birth):
A history of the patient's disease (short listed diseases that the patient suffered, and which may be relevant to the current issue of Health):
Surgery that the pacient received (specify child's age at operation):

Medicamente si alergii

Medications the patient currently takes (please list the names of medicines and dosages)
Allergies to medications:
Other known allergies:

Alte informatii si documente

Relationship to the patient:
Attach file:
Supported file types: *.doc, *.docx, *.odt, *.pdf, *.jpeg, *.jpg, *.png.
Maximum size allowed: 2MB.
Name of the person who completes the form:*
Email:*

Ask the pediatrician your question:

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Sorry, this entry is only available in Romanian.