<html>
<head>
<meta http-equiv=3D"Content-Type" content=3D"text/html; charset=3Diso-8859-1">
</head>
<body>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
Obtener <a href=3D"https://aka.ms/ghei36">
Outlook para Android</a>
</div>
<br>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
De: Formularios de Google<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
Enviado: mi=E9rcoles, 24 de abril 10:35<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
Asunto: Registro de Atenci=F3n Domiciliaria Oncovida<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
Para: abdul2508@hotmail.com<br>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Gracias por rellenar</table>
<a href=3D"https://docs.google.com/forms/d/e/1FAIpQLSdEtSr7xXzExpMb4RkiyPWKMwg1WaFIAImkCVv7UFdpPco75w/viewform?usp=3Dmail_form_link">
</a>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Registro de Atenci=F3n Domiciliaria Oncovida</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Esto es lo que nos has enviado:</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<b>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Registro de Atenci=F3n Domiciliaria Oncovida</table>
</b>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Este es el sistema de registro de atenciones domiciliarias de Oncovida. Debe ser llenado por el prestador individual, y debe realizarse un registro por cada visita domiciliaria. Si usted no es prestador de Oncovida por favor no llene este formulario. A continuaci=F3n indique su correo electr=F3nico.</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Direcci=F3n de correo electr=F3nico *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
abdul2508@hotmail.com</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<b>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Identificaci=F3n del Prestador</table>
</b>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Aqu=ED debe ingresar sus datos personales</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Primer Nombre y Apellido Paterno *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
abdul sarria</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
RUT *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
RUT con Gui=F3n y D=EDgito Verificador, sin puntos ( Ej: 5632200-k)</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
26743483-2</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Tipo *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Si asisten m=E1s de 1 prestador simult=E1neamente, cada uno debe hacer un registro independiente</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
MEDICOENFERMERA/O TENSKINESIOLOGA/OPSICOLOGO NUTRICIONISTA</table>
<br>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<b>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Identificaci=F3n del Paciente</table>
</b>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
En esta secci=F3n debe ingresar los datos del paciente visitado</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<b>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Datos Personales del Paciente</table>
</b>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Ingrese el Rut del Paciente *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
RUT con Gui=F3n y D=EDgito Verificador, sin puntos ( Ej: 5632200-k)</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
3053913-3</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Ingrese el Primer Nombre y Apellido Paterno del Paciente *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
juana delpiano</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Previsi=F3n *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
BANMEDICA CAPREDENACOLMENA CONSALUDCRUZ BLANCADIPRECA FONASAFUNDACIONISAPRES DEL COBRE NUEVA MASVIDAVIDATRES PARTICULAR</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Ciudad *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
antofagasta</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Comuna *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
antofagasta</table>
<br>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<b>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Registro de la Atenci=F3n Domiciliaria</table>
</b>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
En esta secci=F3n debe ingresar los datos de la atenci=F3n domiciliaria</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Tipo de Atenci=F3n *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Domicilio Ambulatorio</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Fecha de la Atenci=F3n *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
D=EDa1234 56789 101112 13141516 171819 20212223 24252627 282930 31 Mesenero febreromarzo abrilmayo juniojulio agostoseptiembre octubrenoviembre diciembre A=F1o1896 18971898 18991900 19011902 19031904 19051906 19071908 19091910 19111912 19131914 19151916 19171918 19191920 19211922 19231924 19251926 19271928 19291930 19311932 19331934 19351936 19371938 19391940 19411942 19431944 19451946 19471948 19491950 19511952 19531954 19551956 19571958 19591960 19611962 19631964 19651966 19671968 19691970 19711972 19731974 19751976 19771978 19791980 19811982 19831984 19851986 19871988 19891990 19911992 19931994 19951996 19971998 19992000 20012002 20032004 20052006 20072008 20092010 20112012 20132014 20152016 20172018 20192020 20212022 20232024 20252026 20272028 20292030 20312032 20332034 20352036 20372038 20392040 20412042 20432044 20452046 20472048 20492050 20512052 20532054 20552056 20572058 20592060 20612062 20632064 20652066 20672068 2069</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Hora de la Atenci=F3n *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
h0001 02030405 060708 09101112 131415 16171819 20212223 : min00 010203 04050607 080910 11121314 151617 18192021 222324 25262728 293031 32333435 363738 39404142 434445 46474849 505152 53545556 575859</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Performance Status ECOG del Paciente *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
0 12 34</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Escala Dolor EVA Actual</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
0</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
1</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
2</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
3</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
4</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
5</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
6</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
7</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
8</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
9</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
10</table>
<table id=3D"entry_1421689035" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Escala Dolor EVA M=E1ximo</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
0</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
1</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
2</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
3</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
4</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
5</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
6</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
7</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
8</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
9</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
10</table>
<table id=3D"entry_1244707512" border=3D"0" cellpadding=3D"5" cellspacing==3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Escala Dolor EVA M=EDnimo</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
0</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
1</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
2</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
3</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
4</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
5</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
6</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
7</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
8</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
9</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
10</table>
<table id=3D"entry_853118630" border=3D"0" cellpadding=3D"5" cellspacing=3D"0">
<tbody>
<tr>
<td rowspan=3D"1" colspan=3D"1">
</td>
</tr>
<tr>
</tr>
</tbody>
</table>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Anamnesis/Evoluci=F3n *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
se atiende llamado de personal de enfermer=EDa que requiere apoyo medico tipo urgencia para valorar paciente por condiciones respiratorias de la paciente. encuentro paciente con antecedentes de linforma no hodgking oxigeno dependiente a 3L x min, hace una semana termino quimioterapia oral, en muy regulares condiciones generales, con cc de aproximadamente 3 dias de evoluci=F3n consistente en aumento de tos expectorante, inapetencia, malestar general, diaforesis, hoy con dificultad respiratoria marcada, manejada en casa con berodual puff esquema de rescate sin respuesta alguna.</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Examen F=EDsico *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
con svt ta 157/97 fc 128 t 37.5 fr 32 sto 60% ( tomada en urgencias, informada por la enfermera) colaboradora, orientada en sus tres esferas mentales, taquipneica, diafor=E9tica, con oxigeno por c=E1nula a 3l x min, mucosas secas, escleras anictericas, conjuntivas rosadas, ruidos card=EDacos taquiarritmicos, campos pulmonares con patr=F3n obstructivo en todas sus =E1reas, roncus y sibilancias, murmullo vesicular disminuido, tirajes intercostales, abdomen blando depresible leve dolor a la palpaci=F3n profunda generalizara, sin signos de irritaci=F3n peritoneal, extremidades sim=E9tricas m=F3viles pulsos presentes.,llenado capilar lento.</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Diagn=F3stico *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
1) insuficiencia respiratoria aguda 2) linfoma no hodgkin</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Plan de Tratamiento e Indicaciones *</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
paciente cursando con signos y s=EDntomas cl=EDnicos de insuficiencia respiratoria aguda secundaria a neumonia?, con alto riesgo de complicaciones por antecedentes patol=F3gicos y estado actual de la paciente, se informa a la paciente y al esposo la necesidad de ser manejada en urgencias por cuadro agudo lo cual inicialmente la paciente se niega lo que retrasa la derivaci=F3n pero posterior acepta, se deriva la paciente a centro de atenci=F3n cl=EDnica antofagasta donde es recibida y ubicada en el box 2 aproximadamente a las 20:30.</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Medicamentos Indicados</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
se deriva a urgencias</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Fecha aproximada del Pr=F3ximo Control con usted</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
D=EDa1234 56789 101112 13141516 171819 20212223 242526 27282930 31 Mesenero febreromarzo abrilmayo juniojulio agostoseptiembre octubrenoviembre diciembre A=F1o1896 18971898 18991900 19011902 19031904 19051906 19071908 19091910 19111912 19131914 19151916 19171918 19191920 19211922 19231924 19251926 19271928 19291930 19311932 19331934 19351936 19371938 19391940 19411942 19431944 19451946 19471948 19491950 19511952 19531954 19551956 19571958 19591960 19611962 19631964 19651966 19671968 19691970 19711972 19731974 19751976 19771978 19791980 19811982 19831984 19851986 19871988 19891990 19911992 19931994 19951996 19971998 19992000 20012002 20032004 20052006 20072008 20092010 20112012 20132014 20152016 20172018 20192020 20212022 20232024 20252026 20272028 20292030 20312032 20332034 20352036 20372038 20392040 20412042 20432044 20452046 20472048 20492050 20512052 20532054 20552056 20572058 20592060 20612062 20632064 20652066 20672068 2069</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Tratamiento Realizado (si corresponde)</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
berodual 4 puff cada 20 min por una hora.</table>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
Derivaci=F3n a otro Prestador Domiciliario</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
S=F3lo llene esta secci=F3n si es m=E9dico y solicita la visita de otro prestador del equipo</table>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color: #fff;">
ENFERMERA TENS NUTRICIONISTA KINESIOLOGO PSICOLOGO</table>
<br>
<br>
<br>
</div>
<div dir=3D"auto" style=3D"direction: ltr; margin: 0; padding: 0; font-family: sans-serif; font-size: 11pt; color: black; ">
<a href=3D"https://docs.google.com/forms?usp=3Dmail_form_link">
</a>
<table width=3D"100%" cellpadding=3D"0" cellspacing=3D"0" style=3D"max-width: 672px; min-width: 154px;">
Crea tu propio formulario de Google</table>
<br>
<br>
<br>
</div>
</body>
</html>
--_000_DM5PR17MB1626030E96C76C43712626B1BE3C0DM5PR17MB1626namp_--