ANAMNESE

CAXITO-2022/2023
Nome: ______________________________________________Idade: ______

Data de nascimento:___/____/___ Sexo:___________Nível académico:

_________não trabalha__________________________Aposentado_________

Estado civil:___________________Religião:________________ reside

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Contacto:____________________________

2- Queixa Principal
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3- Súbita ou progressiva:_________________________________
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Quais mudanças que ocorrem/o que
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Sintomas:_______________________________________________________
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OBSERVAÇÃO
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DATA:____/____/_____

O TÉCNICO (A):
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Nome: Cristina Graciana Daniel
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