SECRETARIA MUNICIPAL DA SADE

Parque dos Lagos

CONSULTA PUERPERAL
UNIDADE DE SADE:___________________________________________________________
DATA:___/___/____
N0 PRONTURIO:____________________________________
NOME:________________________________________________________________________
N0 SIS PR NATAL:____________________________________________________________
DATA DO PARTO:
TIPO DE PARTO: ( ) NORMAL__________________ ( ) CESREA
G_____P_____A______
MAMA:
( ) RACHADURAS ( ) PROCESSO INFLAMATRIO ( ) NORMAL
OUTROS:______________________________________________________________________
OBS:__________________________________________________________________________
EPISIORRAFIA:
( ) PROCESSO INFLAMATRIO ( ) PROCESSO INFECCIOSO ( ) NORMAL
OUTROS:______________________________________________________________________
OBS:__________________________________________________________________________
LQUIOS:
( ) NORMAL ( ) MODERADO ( ) GRANDE QUANTIDADE
INTERCORRNCIAS DURANTE O PARTO: ( ) NO ( )SIM QUAIS:____________________

CONDUTA:
AGENDAMENTO COM GINECOLOG/OBSTETRA-DATA___/___/____
SOLOCITAO DE EXAMES: ( ) NO ( ) SIM QUAIS:_______________________________
ORIENTAES REALIZADAS:
( ) VACINAO
( ) EXAMES DO PEZINHO
( ) ALEITAMENTO MATERNO
( ) COTO UMBILICAL
( ) AGENDAMENTO COM PEDIATRA DATA ___/___/____.

FUNCIONRIO:___________________________________
COREN:___________________________________