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FICHA DE ATENDIMENTO AMBULATORIAL

____ / ____ / ____ Ficha: ______


Animal: _________________________________ Tutor: __________________________________
Espécie: __________________ Sexo: ________ CPF: ___________________________________
Raça: ___________________________________ Contato: ________________________________
Idade: __________________________________ Endereço: _______________________________
Peso: ___________________________________ ________________________________________

 ANAMNESE: _______________________________________________________________________
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- Ambiente: _____________________________ - Ectoparasitas: __________________________
- Alimentação: ___________________________ - Excrementos: ___________________________
- Atividade reprodutiva: ___________________ - Histórico: ______________________________

VACINAÇÃO DATA VERMIFUGAÇÃO DATA

 EXAME FÍSICO:
- Temperatura: _______ - Hidratação: _______ - Pele / Pêlos: ____________________________
- FC (bpm): _________ - FR (mpm): _________ - Cavidade oral: __________________________
- Mucosas:_______________________________ - Abdômen: _____________________________
- Linfonodos: ____________________________ - Membros: ______________________________
- TPC: _________ - Turgor cutâneo: _________ - S. nervoso: _____________________________
- Observações: __________________________________________________________________________

 EXAMES COMPLEMENTARES: _____________________________________________________


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 DIAGNÓSTICO / PROGNÓSTICO: ____________________________________________________


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 TRATAMENTO: ____________________________________________________________________
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 RETORNO: ________________________________________________________________________
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