Ambulator tibbiy karta

Format A-5 O‘zbekiston Respublikasi Sog‘liqni Saqlash Vazirligi muassasa nomi

KTUT bo‘yicha muasssa kodi _____________ O‘z.RSSV 31.12.2020 №363 buyruq bilan tasdiqlangan 025-raqamli tibbiy hujjat shakli

FarPI AMBULATOR TIBBIY KARTA “Ishlab chiqarishda boshqaruv” fakulteti Guruh _________________ Familiya _________________________ Ismi ________________________ Tug‘ilgan sana “______” __________________ ______________________ Doimiy yashash manzili ___________________________________________ _________________________________________________________________ _________________________________________________________________ “D” tashxisi: _______________________________________________ _____________________________________________________________ _____________________________________________________________ Olingan sana _____ ._____._______ Chiqarilgan sana _____ ._____._____