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<div class=3DWordSection1>
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Estimada, <o:p>
</o:p>
</span>
</p>
<p =class=3DMsoNormal>
<span style=3D'mso-fareast-language:EN-US'>
Env=C3=ADo =informe de visita realizada hoy a la paciente.<o:p>
</o:p>
</span>
</p>
<p =class=3DMsoNormal>
<span =style=3D'mso-fareast-language:EN-US'>
<o:p>
&nbsp;</o:p>
</span>
</p>
<p =class=3DMsoNormal>
<span style=3D'mso-fareast-language:EN-US'>
Saludos =cordiales. <o:p>
</o:p>
</span>
</p>
<p class=3DMsoNormal>
<span =style=3D'mso-fareast-language:EN-US'>
<o:p>
&nbsp;</o:p>
</span>
</p>
<div>
<p =class=3DMsoNormal>
<b>
<i>
<span style=3D'color:#1F4E79'>
Muriel Su=C3=A1rez =S.<o:p>
</o:p>
</span>
</i>
</b>
</p>
<p class=3DMsoNormal>
<b>
<i>
<span =style=3D'color:#1F4E79'>
Enfermera<o:p>
</o:p>
</span>
</i>
</b>
</p>
<p =class=3DMsoNormal>
<img width=3D93 height=3D62 =style=3D'width:.9687in;height:.6458in' id=3D"Imagen_x0020_1" =src=3D"cid:image001.jpg@01D548A6.6098B810" =alt=3Dimage003>
<o:p>
</o:p>
</p>
</div>
<p class=3DMsoNormal>
<span =style=3D'mso-fareast-language:EN-US'>
<o:p>
&nbsp;</o:p>
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<div>
<di=v style=3D'border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0cm =0cm 0cm'>
<p class=3DMsoNormal>
<b>
De:</b>
 Formularios de Google =&lt;forms-receipts-noreply@google.com&gt; <br>
<b>
Enviado el:</b>
 jueves, =01 de agosto de 2019 19:53<br>
<b>
Para:</b>
 =murielsuarez@telemed-chile.cl<br>
<b>
Asunto:</b>
 Registro de =Atenci=C3=B3n Domiciliaria Oncovida<o:p>
</o:p>
</p>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<table class=3DMsoNormalTable =border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" =style=3D'width:100.0%;background:#26049A'>
<tr>
<td style=3D'padding:0cm =0cm 0cm 18.0pt'>
<p class=3DMsoNormal>
<span style=3D'border:solid =windowtext 1.0pt;padding:0cm'>
<span style=3D'color:white'>
<img =width=3D100 height=3D100 style=3D'width:1.0416in;height:1.0416in' =id=3D"_x0000_i1025" src=3D"cid:~WRD000.jpg" alt=3D"Imagen quitada por el =remitente. Formularios de =Google">
</span>
</span>
<o:p>
</o:p>
</p>
</td>
</tr>
</table>
<div>
<div =style=3D'border:none;border-bottom:solid #E0E0E0 1.0pt;padding:0cm 0cm =0cm 0cm;min-width: 154px'>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center;background:white'>
<span =style=3D'font-family:"Helvetica",sans-serif;display:none'>
<o:p>
&nbsp;</o:=p>
</span>
</p>
<div align=3Dcenter>
<table class=3DMsoNormalTable =border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" =style=3D'width:100.0%;background:white'>
<tr>
<td style=3D'padding:0cm 0cm =0cm 0cm'>
</td>
</tr>
<tr>
<td style=3D'padding:0cm 0cm 0cm 0cm'>
<div>
<p =class=3DMsoNormal style=3D'line-height:13.5pt'>
<b>
<span =style=3D'font-size:10.0pt;color:#424242'>
Gracias por rellenar <a =href=3D"https://docs.google.com/forms/d/e/1FAIpQLSdEtSr7xXzExpMb4RkiyPWKM=wg1WaFIAImkCVv7UFdpPco75w/viewform?usp=3Dmail_form_link">
Registro de =Atenci=C3=B3n Domiciliaria =Oncovida</a>
<o:p>
</o:p>
</span>
</b>
</p>
</div>
</td>
</tr>
<tr>
<td =style=3D'padding:0cm 0cm 0cm 0cm'>
</td>
</tr>
<tr>
<td style=3D'padding:0cm =0cm 0cm 0cm'>
<div>
<p class=3DMsoNormal =style=3D'line-height:13.5pt'>
<span =style=3D'font-size:10.0pt;color:#424242'>
Esto es lo que nos has =enviado:<o:p>
</o:p>
</span>
</p>
</div>
</td>
</tr>
<tr>
<td =style=3D'padding:0cm 0cm 0cm 0cm'>
<div>
<div>
<h1 =style=3D'mso-margin-top-alt:8.05pt;margin-right:0cm;margin-bottom:8.05pt;=margin-left:0cm'>
<span style=3D'color:black'>
Registro de Atenci=C3=B3n =Domiciliaria Oncovida</span>
<o:p>
</o:p>
</h1>
<div =style=3D'margin-bottom:12.0pt;white-space:pre-wrap;word-wrap:break-word'>
=<p class=3DMsoNormal>
<span style=3D'color:black'>
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=C3=B3n indique su correo =electr=C3=B3nico.</span>
<o:p>
</o:p>
</p>
</div>
</div>
<div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Direcci=C3=B3n de correo electr=C3=B3nico =</span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
murielsuarez@telemed-chile.cl<o:p>
</o:p>
</span>
</=p>
</div>
</div>
</div>
</div>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt;max-width:100%'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<p class=3DMsoNormal =align=3Dright style=3D'text-align:right;vertical-align:middle'>
<span =style=3D'color:black;border:solid windowtext 1.0pt;padding:0cm'>
<img =border=3D0 width=3D100 height=3D100 =style=3D'width:1.0416in;height:1.0416in' id=3D"_x0000_i1026" =src=3D"cid:~WRD000.jpg" alt=3D"Imagen quitada por el remitente. Imagen =sin leyenda">
</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<h2 =style=3D'mso-margin-top-alt:24.0pt;margin-right:-4.8pt;margin-bottom:0cm;=margin-left:-4.8pt;margin-bottom:.0001pt;background:#EEEEEE;vertical-alig=n:middle'>
<span style=3D'color:black'>
Identificaci=C3=B3n del =Prestador</span>
<o:p>
</o:p>
</h2>
<div>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:black'>
Aqu=C3=AD =debe ingresar sus datos =personales</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Primer =Nombre y Apellido Paterno </span>
</b>
<span =class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Muriel =Su=C3=A1rez<o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
RUT =</span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'margin-top:1.2pt;margin-bottom:3.0pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:#666666'>
RUT con =Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: =5632200-k)<o:p>
</o:p>
</span>
</p>
</div>
<div style=3D'border:solid silver =1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
18955696-9<o:p>
</o:p>
</span>
</p>
</div>
</div>
</div=>
</div>
<p class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
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<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Tipo =</span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'margin-top:1.2pt;margin-bottom:3.0pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:#666666'>
Si asisten =m=C3=A1s de 1 prestador simult=C3=A1neamente, cada uno debe hacer un =registro independiente<o:p>
</o:p>
</span>
</p>
</div>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span =style=3D'color:black'>
[ENFERMERA/O&nbsp;\/] =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt;max-width:100%'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<p class=3DMsoNormal =align=3Dright style=3D'text-align:right;vertical-align:middle'>
<span =style=3D'color:black;border:solid windowtext 1.0pt;padding:0cm'>
<img =border=3D0 width=3D100 height=3D100 =style=3D'width:1.0416in;height:1.0416in' id=3D"_x0000_i1027" =src=3D"cid:~WRD000.jpg" alt=3D"Imagen quitada por el remitente. Imagen =sin leyenda">
</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<h2 =style=3D'mso-margin-top-alt:24.0pt;margin-right:-4.8pt;margin-bottom:0cm;=margin-left:-4.8pt;margin-bottom:.0001pt;background:#EEEEEE;vertical-alig=n:middle'>
<span style=3D'color:black'>
Identificaci=C3=B3n del =Paciente</span>
<o:p>
</o:p>
</h2>
<div>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:black'>
En esta =secci=C3=B3n debe ingresar los datos del paciente =visitado</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<h2 =style=3D'mso-margin-top-alt:24.0pt;margin-right:-4.8pt;margin-bottom:0cm;=margin-left:-4.8pt;margin-bottom:.0001pt;background:#EEEEEE;vertical-alig=n:middle'>
<span style=3D'color:black'>
Datos Personales del =Paciente</span>
<o:p>
</o:p>
</h2>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Ingrese =el Rut del Paciente </span>
</b>
<span =class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'margin-top:1.2pt;margin-bottom:3.0pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:#666666'>
RUT con =Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: =5632200-k)<o:p>
</o:p>
</span>
</p>
</div>
<div style=3D'border:solid silver =1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
6070934-3<o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
=</div>
<p class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Ingrese =el Primer Nombre y Apellido Paterno del Paciente </span>
</b>
<span =class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Ruth =Aravena<o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Previsi=C3=B3n </span>
</b>
<span =class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<p= class=3DMsoNormal style=3D'vertical-align:middle'>
<span =style=3D'color:black'>
[COLMENA&nbsp;\/] =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Ciudad =</span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Curacav=C3=AD<o:p>
</o:p>
</span>
</p>
</div>
</div>
</=div>
</div>
<p class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Comuna =</span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Curacav=C3=AD<o:p>
</o:p>
</span>
</p>
</div>
</div>
</=div>
</div>
<p class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt;max-width:100%'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<p class=3DMsoNormal =align=3Dright style=3D'text-align:right;vertical-align:middle'>
<span =style=3D'color:black;border:solid windowtext 1.0pt;padding:0cm'>
<img =border=3D0 width=3D100 height=3D100 =style=3D'width:1.0416in;height:1.0416in' id=3D"_x0000_i1028" =src=3D"cid:~WRD000.jpg" alt=3D"Imagen quitada por el remitente. Imagen =sin leyenda">
</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<h2 =style=3D'mso-margin-top-alt:24.0pt;margin-right:-4.8pt;margin-bottom:0cm;=margin-left:-4.8pt;margin-bottom:.0001pt;background:#EEEEEE;vertical-alig=n:middle'>
<span style=3D'color:black'>
Registro de la Atenci=C3=B3n =Domiciliaria</span>
<o:p>
</o:p>
</h2>
<div>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:black'>
En esta =secci=C3=B3n debe ingresar los datos de la atenci=C3=B3n =domiciliaria</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Tipo de =Atenci=C3=B3n </span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<p= class=3Dss-choice-item =style=3D'margin:0cm;margin-bottom:.0001pt;text-indent:-18.0pt;line-height=:15.6pt;mso-list:l1 level1 lfo1;vertical-align:middle'>
<![if =!supportLists]>
<span style=3D'font-size:10.0pt;font-family:Symbol'>
<span =style=3D'mso-list:Ignore'>
=C2=B7<span style=3D'font:7.0pt "Times New =Roman"'>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =</span>
</span>
</span>
<![endif]>
<span =class=3Dss-choice-item-control>
<span =style=3D'color:black'>
(X)</span>
</span>
<span style=3D'color:black'>
 =<span class=3Dss-choice-label>
Domicilio</span>
 </span>
<o:p>
</o:p>
</p>
<p =class=3Dss-choice-item =style=3D'margin:0cm;margin-bottom:.0001pt;text-indent:-18.0pt;line-height=:15.6pt;mso-list:l1 level1 lfo1;vertical-align:middle'>
<![if =!supportLists]>
<span style=3D'font-size:10.0pt;font-family:Symbol'>
<span =style=3D'mso-list:Ignore'>
=C2=B7<span style=3D'font:7.0pt "Times New =Roman"'>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =</span>
</span>
</span>
<![endif]>
<span =class=3Dss-choice-item-control>
<span =style=3D'color:black'>
(&nbsp;)</span>
</span>
<span style=3D'color:black'>
 =<span class=3Dss-choice-label>
Ambulatorio</span>
 =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Fecha de =la Atenci=C3=B3n </span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv>
<div style=3D'border:solid gainsboro 1.0pt;padding:0cm 0cm 0cm =2.0pt;margin-left:2.25pt;margin-top:3.0pt;margin-right:2.25pt;margin-bott=om:3.0pt;min-height:32px;display:inline-block'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:black'>
[1&nbsp;\/] =[agosto&nbsp;\/] [2019&nbsp;\/] =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Hora de =la Atenci=C3=B3n </span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv>
<div style=3D'border:solid gainsboro 1.0pt;padding:0cm 0cm 0cm =2.0pt;margin-left:2.25pt;margin-top:3.0pt;margin-right:2.25pt;margin-bott=om:3.0pt;min-height:32px;display:inline-block'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:black'>
[15&nbsp;\/] =: [30&nbsp;\/] </span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Performance Status ECOG del Paciente =</span>
</b>
<span class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<p= class=3DMsoNormal style=3D'vertical-align:middle'>
<span =style=3D'color:black'>
[3&nbsp;\/] =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt;overflow-x:auto'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Escala =Dolor EVA Actual </span>
</b>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<table =class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 =id=3D"entry_1421689035">
<tr>
<td style=3D'padding:3.75pt 3.75pt 3.75pt =3.75pt'>
</td>
<td style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p =class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
0<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
1<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
2<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
3<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
4<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
5<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
6<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
7<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
8<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
9<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
<p class=3DMsoNormal =align=3Dcenter style=3D'text-align:center'>
10<o:p>
</o:p>
</p>
</td>
<td =style=3D'padding:3.75pt 3.75pt 3.75pt 3.75pt'>
</td>
</tr>
<tr>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =0cm'>
</td>
<td style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt =6.0pt 3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(&nbsp;)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
<p class=3DMsoNormal align=3Dcenter =style=3D'text-align:center'>
<span =style=3D'color:#666666'>
(X)<o:p>
</o:p>
</span>
</p>
</div>
</td>
<td =style=3D'border:solid #D3D8D3 1.0pt;padding:6.0pt 3.0pt 6.0pt =3.0pt'>
<div>
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Anamnesis/Evoluci=C3=B3n </span>
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<span =style=3D'color:#545454'>
Se=C3=B1ora Ruth con diagn=C3=B3stico de =C=C3=A1ncer vaginal no metast=C3=A1sico. Con antecedente de HTA en =tratamiento. Antecedentes quir=C3=BArgicos: Histerectom=C3=ADa =(Octubre/2018) con biopsia de tejido normal. Evoluciona con sangrado =vaginal escaso, por lo que se decide resuturar cirug=C3=ADa previa y =realizar nueva biopsia, la cual evidencia un Adenocarcinoma Glandular en =vagina. Se ordena manejo con radioterapia, actualmente, paciente se =encuentra completando estudios para su inicio. Paciente en estado ECOG =3, con antecedente de alto nivel de dolor EVA 10/10, actualmente en =periodo de ajuste de f=C3=A1rmacos. Durante la semana, paciente se =encuentra en tratamiento con 1 parche Transtec + paracetamol 1 gr c/8 =hrs. Sin embargo, refiere que efecto de analgesia no logra cubrir por =completo intervalo entre las ingestas, sufriendo diariamente dolor EVA 7 ==E2=80=93 8/10 con duraci=C3=B3n de 20 min aprox, necesitando adelantar =tratamiento o recurrir a Tramadol en gotas el cual no logra reducir el =dolor. Adem=C3=A1s, dos d=C3=ADas a la semana aprox. Presenta dolor EVA =9 =E2=80=93 10 /10, que se mantiene durante todo el d=C3=ADa, de =dif=C3=ADcil manejo, incapacit=C3=A1ndola completamente para realizar =sus actividades diarias, manteni=C3=A9ndose en cama durante todo el =d=C3=ADa. Dolor m=C3=ADnimo que presenta es EVA 2/10 el cual asocia a =una dismenorrea. El dolor inicia en coxis y se irradia al hipogastrio, =durante la ultima semana paciente refiere que ha comenzado a =intensificarse en fosa iliaca derecha. Realizo educaci=C3=B3n de =indicaci=C3=B3n medica realizada ayer, establezco horarios para el =cumplimiento de su nuevo tratamiento: Paracetamol 1 gr (07-15-23), =Tramadol 50 mg c/8 (11-19- 03), 1 Parche completo Transtec. Debido a =este nivel de dolor, paciente se encuentra inapetente, manteniendo una =baja ingesta, la cual ha sido bien tolerada, no presenta nauseas ni =v=C3=B3mitos. Respecto a su habito de sue=C3=B1o, paciente es usuaria de =melatonina con la cual concilia el sue=C3=B1o, episodios de dolor =nocturno han disminuido desde inicio de tratamiento farmacol=C3=B3gico. =Respecto a su habito de eliminaci=C3=B3n, semana pasada comienza con =dificultad y dolor al realizar deposiciones, por lo que inicia =tratamiento con lactulosa, la cual ha facilitado la evacuaci=C3=B3n =intestinal. Paciente presenta labilidad emocional, presentando menor =nivel de =C3=A1nimo durante episodios prolongados de dolor. Adem=C3=A1s, =se encuentra angustiada y asustada, debido a que su tratamiento aun no =puede iniciarlo. <o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
</div>
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</p>
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<b>
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Examen =F=C3=ADsico </span>
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<span class=3Dss-required-asterisk>
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<span =style=3D'color:#C43B1D'>
*</span>
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</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Al control de signos vitales normoc=C3=A1rdica =(63 LPM), eupneica (14 RPM), hipertensa (152/ 90 mmhg), Afebril =(36.4=C2=BAC). Actualmente con dolor EVA 8/10 el cual comienza a =disminuir durante la visita. Glasgow 15. Al examen f=C3=ADsico, paciente =mantiene posici=C3=B3n anti=C3=A1lgica, recostada en sof=C3=A1. Mantiene =piel y mucosas hidratadas, bien perfundida, pupilas isoc=C3=B3ricas y =reactivas. Buena mec=C3=A1nica respiratoria, a la auscultaci=C3=B3n =mp(+) sin ruidos agregados, abdomen blando, depresible, doloroso en =hipogastrio y fosa iliaca derecha, con RHA (+). Extremidades superiores =e inferiores m=C3=B3viles y sanas son pulsos presentes. Vuelvo a =reforzar en importancia en el cumplimiento de tratamiento anti =hipertensivo. <o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Diagn=C3=B3stico </span>
</b>
<span =class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Ca =Vaginal<o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Plan de =Tratamiento e Indicaciones </span>
</b>
<span =class=3Dss-required-asterisk>
<b>
<span =style=3D'color:#C43B1D'>
*</span>
</b>
</span>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<d=iv style=3D'border:solid silver 1.0pt;padding:4.0pt 4.0pt 4.0pt =4.0pt;max-width:90%;white-space:pre-wrap'>
<p class=3DMsoNormal =style=3D'background:#EEEEEE;vertical-align:middle'>
<span =style=3D'color:#545454'>
Manejo del dolor. Complementar manejo de dolor =con terapias alternativas, mantener musicoterapia. =<o:p>
</o:p>
</span>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Medicamentos Indicados =</span>
</b>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span style=3D'color:black'>
Fecha =aproximada del Pr=C3=B3ximo Control con usted =</span>
</b>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<div>
<div style=3D'border:solid =gainsboro 1.0pt;padding:0cm 0cm 0cm =2.0pt;margin-left:2.25pt;margin-top:3.0pt;margin-right:2.25pt;margin-bott=om:3.0pt;min-height:32px;display:inline-block'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:black'>
[8&nbsp;\/] =[agosto&nbsp;\/] [2019&nbsp;\/] =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Tratamiento Realizado (si corresponde) =</span>
</b>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
</p>
<div>
<div =style=3D'margin-top:9.0pt;margin-bottom:9.0pt'>
<div =style=3D'margin-bottom:18.0pt;max-width:100%'>
<div =style=3D'margin-top:9.95pt;margin-bottom:9.95pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<b>
<span =style=3D'color:black'>
Derivaci=C3=B3n a otro Prestador Domiciliario =</span>
</b>
<b>
<o:p>
</o:p>
</b>
</p>
</div>
<div =style=3D'margin-top:1.2pt;margin-bottom:3.0pt'>
<p class=3DMsoNormal =style=3D'vertical-align:middle'>
<span style=3D'color:#666666'>
S=C3=B3lo =llene esta secci=C3=B3n si es m=C3=A9dico y solicita la visita de otro =prestador del equipo<o:p>
</o:p>
</span>
</p>
</div>
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=C2=B7<span style=3D'font:7.0pt "Times New =Roman"'>
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; =</span>
</span>
</span>
<![endif]>
<span =class=3Dss-choice-item-control>
<span =style=3D'color:black'>
[&nbsp;]</span>
</span>
<span style=3D'color:black'>
 =<span class=3Dss-choice-label>
ENFERMERA</span>
 </span>
<o:p>
</o:p>
</p>
<p =class=3Dss-choice-item =style=3D'margin:0cm;margin-bottom:.0001pt;text-indent:-18.0pt;line-height=:15.6pt;mso-list:l0 level1 lfo2;vertical-align:middle'>
<![if =!supportLists]>
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<span =style=3D'mso-list:Ignore'>
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</span>
</span>
<![endif]>
<span =class=3Dss-choice-item-control>
<span =style=3D'color:black'>
[&nbsp;]</span>
</span>
<span style=3D'color:black'>
 =<span class=3Dss-choice-label>
TENS</span>
 </span>
<o:p>
</o:p>
</p>
<p =class=3Dss-choice-item =style=3D'margin:0cm;margin-bottom:.0001pt;text-indent:-18.0pt;line-height=:15.6pt;mso-list:l0 level1 lfo2;vertical-align:middle'>
<![if =!supportLists]>
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<span =style=3D'mso-list:Ignore'>
=C2=B7<span style=3D'font:7.0pt "Times New =Roman"'>
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<![endif]>
<span =class=3Dss-choice-item-control>
<span =style=3D'color:black'>
[&nbsp;]</span>
</span>
<span style=3D'color:black'>
 =<span class=3Dss-choice-label>
NUTRICIONISTA</span>
 =</span>
<o:p>
</o:p>
</p>
<p class=3Dss-choice-item =style=3D'margin:0cm;margin-bottom:.0001pt;text-indent:-18.0pt;line-height=:15.6pt;mso-list:l0 level1 lfo2;vertical-align:middle'>
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[&nbsp;]</span>
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KINESIOLOGO</span>
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</o:p>
</p>
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[&nbsp;]</span>
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PSICOLOGO</span>
 =</span>
<o:p>
</o:p>
</p>
</div>
</div>
</div>
<p =class=3DMsoNormal>
<o:p>
&nbsp;</o:p>
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<p class=3DMsoNormal =align=3Dright style=3D'text-align:right;vertical-align:middle'>
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<img =border=3D0 width=3D100 height=3D100 =style=3D'width:1.0416in;height:1.0416in' id=3D"_x0000_i1029" =src=3D"cid:~WRD000.jpg" alt=3D"Imagen quitada por el remitente. Imagen =sin =leyenda">
</span>
<o:p>
</o:p>
</p>
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</td>
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<t=r>
<td style=3D'padding:0cm 0cm 0cm =0cm'>
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<a =href=3D"https://docs.google.com/forms?usp=3Dmail_form_link">
<span =style=3D'font-size:10.0pt;color:#424242'>
Crea tu propio formulario de =Google</span>
</a>
<o:p>
</o:p>
</p>
</td>
</tr>
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