Post on 01-Mar-2018
7/25/2019 Ficha Clinica en Blanco
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FICHA CLINICA PODOLOGICA FICHA Nro____
Nombre completo: _______________________________________________________________________________Sexo:______Direccin : __________________________________________________________________________________________
Telfono : __________________________F.Nacimiento:____________________________ Edad:____________________ c!pacin :__________________________________________________________________________________________ Centro de deri"acin:________________________________________________________________________________________
Enfermedad #!e padece:
$D HTA Artriti% Artro%i% %teopr tro%:__________________________________&edicamento% :__________________________________________________________________________________________
OBSERVACIONES:
Calzado adecuado Inadecuado Muy inadecuado _____________________________________________ _____________________________________________
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'e%o : _______(ilo%
E%tat!ra :_______mt
N) cal*ado :________
EXAMEN DEL PIE
PULSO PEDIO (+) (-)
Derecho Izquierdo
PULSO TIBIAL (+) (-)
Der Izq
TEMPERATURA
Fra Norm Caliente
PROBL CIRCULATORIOS
Si No
PIEL
Seca Normal Humeda
INDICACIONES:
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FECHA :____/____/________
TRATANTE:
TRATAMIENTO:
ASE'SIAF&ENTACI+N,I&'IE-A DE S/CSNICT&IADES'IC,I-ACI+N/ESECADHE,T&IADES0ASTAD',IDASE'SIA FINA,
T/S:__________________________________________________________________
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SIMBOLOGIA