<div dir=3D"ltr">
<br>
<br>
<div class=3D"gmail_quote">
<div dir=3D"ltr" class==3D"gmail_attr">
---------- Forwarded message ---------<br>
From: <strong class=3D"gmail_sendername" dir=3D"auto">
Formularios de Google</strong>
 <span dir=3D"ltr">
&lt;<a href=3D"mailto:forms-receipts-noreply@google.com">
forms-receipts-noreply@google.com</a>
&gt;</span>
<br>
Date: mi=C3=A9., 13 mar. 2019 a las 22:02<br>
Subject: Registro de Atenci=C3=B3n Domiciliaria Oncovida<br>
To:  &lt;<a href=3D"mailto:gaby.martinezt@gmail.com">
gaby.martinezt@gmail.com</a>
&gt;<br>
</div>
<br>
<br>
<div style=3D"font-family:Roboto,Helvetica,Arial,sans-serif;margin:0;padding:0;height:100%;width:100%">
<table border=3D"0" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:rgb(38,4,154)" width=3D"100%">
<tbody>
<tr height=3D"64px">
<td style=3D"padding-left:24px">
<img alt=3D"Formularios de Google" height=3D"26px" style=3D"display:inline-block;margin:0;vertical-align:middle" width=3D"143px" src=3D"https://www.gstatic.com/docs/forms/google_forms_logo_lockup_white_2x.png">
</td>
</tr>
</tbody>
</table>
<div style=3D"padding:24px;background-color:rgb(229,218,254)">
<div align=3D"center" style=3D"background-color:#fff;border-bottom:1px solid #e0e0e0;margin:0 auto;max-width:624px;min-width:154px;padding:0 24px">
<table align=3D"center" cellpadding=3D"0" cellspacing=3D"0" style=3D"background-color:#fff" width=3D"100%">
<tbody>
<tr height=3D"24px">
<td>
</td>
</tr>
<tr>
<td>
<div style=3D"font-size:13px;line-height:18px;color:#424242;font-weight:700">
Gracias por rellenar <a href=3D"https://docs.google.com/forms/d/e/1FAIpQLSdEtSr7xXzExpMb4RkiyPWKMwg1WaFIAImkCVv7UFdpPco75w/viewform?usp=3Dmail_form_link" target=3D"_blank">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</a>
</div>
</td>
</tr>
<tr height=3D"12px">
</tr>
<tr>
<td>
<div style=3D"font-size:13px;line-height:18px;color:#424242">
Esto es lo que nos has enviado:</div>
</td>
</tr>
<tr>
<td>
<div class=3D"m_848427763299318076ss-form-container">
<div class=3D"m_848427763299318076ss-form-heading">
<h1 class=3D"m_848427763299318076ss-form-title" dir=3D"ltr" style=3D"margin:.67em 0">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</h1>
<div class=3D"m_848427763299318076ss-form-desc m_848427763299318076ss-no-ignore-whitespace" style=3D"font:inherit;width:99%;margin:0 0 1em;white-space:pre-wrap;word-wrap:break-word">
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.</div>
</div>
<div class=3D"m_848427763299318076ss-form">
<form method=3D"GET" id=3D"m_848427763299318076ss-form" target=3D"_blank">
<br>
<div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076emailAddress">
<div class=3D"m_848427763299318076ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Direcci=C3=B3n de correo electr=C3=B3nico<label for=3D"m_848427763299318076emailAddress">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text m_848427763299318076ss-printable-text-line" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
<a href=3D"mailto:gaby.martinezt@gmail.com" target=3D"_blank">
gaby.martinezt@gmail.com</a>
</div>
</div>
</div>
</div>
<div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
</h2>
<div style=3D"text-align:right">
<img class=3D"m_848427763299318076ss-image" title=3D"" src=3D"https://lh4.googleusercontent.com/7WxFGV5oEKKf6rzNb0Iw8YpwJxhebvN37sfEgvirGhVlOohE3P9pNEU3e4QpKhgH1mM-c1xwGQ" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Prestador</h2>
<div class=3D"m_848427763299318076ss-page-description m_848427763299318076ss-no-ignore-whitespace" dir=3D"auto" style=3D"white-space:pre-wrap;word-wrap:break-word">
Aqu=C3=AD debe ingresar sus datos personales</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_579114469">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Primer Nombre y Apellido Paterno<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Gabriela Martinez</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1276273985">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
RUT<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
RUT con Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: 5632200-k)</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
15952773-5</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-select" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_133691676">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
Si asisten m=C3=A1s de 1 prestador simult=C3=A1neamente, cada uno debe hacer un registro independiente</div>
</label>
<select name=3D"entry.133691676" disabled id=3D"m_848427763299318076entry_133691676">
<option value=3D"">
</option>
<option value=3D"MEDICO" disabled>
MEDICO</option>
 <option value=3D"ENFERMERA/O" disabled selected>
ENFERMERA/O</option>
 <option value=3D"TENS" disabled>
TENS</option>
 <option value=3D"KINESIOLOGA/O" disabled>
KINESIOLOGA/O</option>
 <option value=3D"PSICOLOGO" disabled>
PSICOLOGO</option>
 <option value==3D"NUTRICIONISTA" disabled>
NUTRICIONISTA</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
</h2>
<div style=3D"text-align:right">
<img class=3D"m_848427763299318076ss-image" title=3D"" src=3D"https://lh4.googleusercontent.com/3_W3VwwMo1GiMEhNrv87B57PDW8BccI5mhSfE6p-lSCi4ennEWvZyCNRVNh9IS3zA_JNCIBLbA" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Paciente</h2>
<div class=3D"m_848427763299318076ss-page-description m_848427763299318076ss-no-ignore-whitespace" dir=3D"auto" style=3D"white-space:pre-wrap;word-wrap:break-word">
En esta secci=C3=B3n debe ingresar los datos del paciente visitado</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-section-header" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-section-title" style=3D"background-color:#eee;padding:0.4em">
Datos Personales del Paciente</h2>
<div class=3D"m_848427763299318076ss-section-description m_848427763299318076ss-no-ignore-whitespace" style=3D"margin-top:0.5em;white-space:pre-wrap;word-wrap:break-word">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_823811303">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Rut del Paciente<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
RUT con Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: 5632200-k)</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
4302990-8</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1959365839">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Primer Nombre y Apellido Paterno del Paciente<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Pedro Caro</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-select" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_545002227">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Previsi=C3=B3n<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<select name=3D"entry.545002227" disabled id=3D"m_848427763299318076entry_545002227">
<option value=3D"">
</option>
<option value=3D"BANMEDICA" disabled>
BANMEDICA</option>
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CAPREDENA</option>
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COLMENA</option>
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CONSALUD</option>
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CRUZ BLANCA</option>
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DIPRECA</option>
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FONASA</option>
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FUNDACION</option>
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ISAPRES DEL COBRE</option>
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NUEVA MASVIDA</option>
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VIDATRES</option>
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PARTICULAR</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1900161356">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ciudad<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
La Union</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1298871758">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Comuna<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
La Union</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
</h2>
<div style=3D"text-align:right">
<img class=3D"m_848427763299318076ss-image" title=3D"" src=3D"https://lh3.googleusercontent.com/a--QM0tHOY2N-ywEy9inrBWw-4f6j9Ofzul9VQSNQn1ad8mPRl1_kCJQR9ynQdP2swvENM5UdQ" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_848427763299318076ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Registro de la Atenci=C3=B3n Domiciliaria</h2>
<div class=3D"m_848427763299318076ss-page-description m_848427763299318076ss-no-ignore-whitespace" dir=3D"auto" style=3D"white-space:pre-wrap;word-wrap:break-word">
En esta secci=C3=B3n debe ingresar los datos de la atenci=C3==B3n domiciliaria</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-radio" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_2073233714">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo de Atenci=C3=B3n<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<ul class=3D"m_848427763299318076ss-choices" style=3D"list-style:none;padding:0;margin:.5em 0 0">
<li class=3D"m_848427763299318076ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_848427763299318076ss-choice-item-control m_848427763299318076goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled checked value=3D"Domicilio" id=3D"m_848427763299318076group_1222378237_1" class=3D"m_848427763299318076ss-q-radio">
</span>
<span class=3D"m_848427763299318076ss-choice-label">
Domicilio</span>
</label>
</li>
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<label>
<span class=3D"m_848427763299318076ss-choice-item-control m_848427763299318076goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled value=3D"Ambulatorio" id=3D"m_848427763299318076group_1222378237_2" class=3D"m_848427763299318076ss-q-radio">
</span>
<span class=3D"m_848427763299318076ss-choice-label">
Ambulatorio</span>
</label>
</li>
</ul>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-date" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1705849412">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Fecha de la Atenci=C3=B3n<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-date">
<div class=3D"m_848427763299318076ss-datetime-box m_848427763299318076goog-inline-block" style=3D"border:1px solid #dcdcdc;margin-right:2em;min-height:32px;padding-left:3px;vertical-align:middle;margin:4px 3px;display:inline-block">
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<option value=3D"">
D=C3=ADa</option>
<option value=3D"1">
1</option>
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2</option>
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3</option>
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4</option>
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5</option>
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6</option>
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7</option>
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8</option>
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9</option>
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10</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
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16</option>
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17</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
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23</option>
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24</option>
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25</option>
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26</option>
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27</option>
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28</option>
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29</option>
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30</option>
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31</option>
</select>
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Mes</option>
<option value=3D"1">
enero</option>
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febrero</option>
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marzo</option>
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abril</option>
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mayo</option>
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junio</option>
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julio</option>
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agosto</option>
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septiembre</option>
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octubre</option>
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noviembre</option>
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diciembre</option>
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=20<select name=3D"entry.1705849412_year" disabled id=3D"m_848427763299318076entry.1705849412_year">
<option value=3D"">
A=C3=B1o</option>
<option value=3D"1896">
1896</option>
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1897</option>
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1898</option>
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1899</option>
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1900</option>
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1901</option>
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1902</option>
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1903</option>
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1904</option>
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1905</option>
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1906</option>
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1907</option>
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1908</option>
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1909</option>
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1910</option>
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1911</option>
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1912</option>
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1913</option>
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1914</option>
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1915</option>
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1916</option>
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1917</option>
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1918</option>
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1919</option>
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1920</option>
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1921</option>
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1922</option>
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1923</option>
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1924</option>
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1925</option>
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1926</option>
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1927</option>
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1928</option>
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1929</option>
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1930</option>
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1931</option>
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1932</option>
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1933</option>
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1934</option>
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1935</option>
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1936</option>
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1937</option>
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1938</option>
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1939</option>
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1940</option>
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1941</option>
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1942</option>
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1943</option>
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1944</option>
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1945</option>
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1946</option>
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1947</option>
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1948</option>
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1949</option>
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1950</option>
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1951</option>
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1952</option>
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1953</option>
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1954</option>
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1955</option>
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1956</option>
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1957</option>
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1958</option>
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1959</option>
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1960</option>
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1961</option>
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1962</option>
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1963</option>
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1964</option>
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1965</option>
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1966</option>
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1967</option>
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1968</option>
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1969</option>
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1970</option>
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1971</option>
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1972</option>
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1973</option>
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1974</option>
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1975</option>
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1976</option>
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1977</option>
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1978</option>
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1979</option>
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1980</option>
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1981</option>
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1982</option>
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1983</option>
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1984</option>
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1985</option>
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1986</option>
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1987</option>
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1988</option>
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1989</option>
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1990</option>
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1991</option>
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1992</option>
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1993</option>
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1994</option>
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1995</option>
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1996</option>
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1997</option>
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1998</option>
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1999</option>
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2000</option>
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2001</option>
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2002</option>
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2003</option>
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2004</option>
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2005</option>
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2006</option>
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2007</option>
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2008</option>
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2009</option>
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2010</option>
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2011</option>
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2012</option>
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2013</option>
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2014</option>
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2015</option>
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2016</option>
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2017</option>
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2018</option>
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2019</option>
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2020</option>
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2021</option>
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2022</option>
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2023</option>
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2024</option>
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2025</option>
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2026</option>
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2027</option>
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2028</option>
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2029</option>
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2030</option>
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2031</option>
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2032</option>
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2033</option>
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2034</option>
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2035</option>
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2036</option>
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2037</option>
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2038</option>
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2039</option>
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2040</option>
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2041</option>
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2042</option>
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2043</option>
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2044</option>
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2045</option>
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2046</option>
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2047</option>
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2048</option>
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2049</option>
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2050</option>
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2051</option>
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2052</option>
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2053</option>
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2054</option>
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2055</option>
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2056</option>
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2057</option>
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2058</option>
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2059</option>
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2060</option>
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2061</option>
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2062</option>
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2063</option>
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2064</option>
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2065</option>
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2066</option>
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2067</option>
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2068</option>
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2069</option>
</select>
</div>
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-time" style=3D"margin:12px 0;font:inherit">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_206244955">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Hora de la Atenci=C3=B3n<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-time">
<div class=3D"m_848427763299318076ss-datetime-box m_848427763299318076goog-inline-block" dir=3D"ltr" style=3D"border:1px solid #dcdcdc;margin-right:2em;min-height:32px;padding-left:3px;vertical-align:middle;margin:4px 3px;display:inline-block">
<select name=3D"entry.206244955_hour" disabled id=3D"m_848427763299318076entry.206244955_hour">
<option value=3D"">
h</option>
<option value=3D"00">
00</option>
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01</option>
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02</option>
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03</option>
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04</option>
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05</option>
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06</option>
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07</option>
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08</option>
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09</option>
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10</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
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16</option>
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17</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
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23</option>
</select>
:<select name=3D"entry.206244955_minute" disabled id=3D"m_848427763299318076entry.206244955_minute">
<option value=3D"">
min</option>
<option value=3D"00" selected>
00</option>
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01</option>
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02</option>
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03</option>
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04</option>
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05</option>
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06</option>
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07</option>
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08</option>
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09</option>
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10</option>
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11</option>
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12</option>
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13</option>
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14</option>
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15</option>
 <option value=3D"16">
16</option>
 <option value=3D"17">
17</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
 <option value=3D"23">
23</option>
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24</option>
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25</option>
 <option value=3D"26">
26</option>
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27</option>
 <option value=3D"28">
28</option>
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29</option>
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30</option>
 <option value=3D"31">
31</option>
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32</option>
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33</option>
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34</option>
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35</option>
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36</option>
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37</option>
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38</option>
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39</option>
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40</option>
 <option value=3D"41">
41</option>
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42</option>
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43</option>
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44</option>
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45</option>
 <option value=3D"46">
46</option>
 <option value=3D"47">
47</option>
 <option value=3D"48">
48</option>
 <option value=3D"49">
49</option>
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50</option>
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51</option>
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52</option>
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53</option>
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54</option>
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55</option>
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56</option>
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57</option>
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58</option>
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59</option>
</select>
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</div>
</div>
</div>
</div>
</div>
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<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Performance Status ECOG del Paciente<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
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<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
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0</option>
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1</option>
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2</option>
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3</option>
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4</option>
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</div>
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<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1716090865">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA Actual</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
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</td>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_3" style=3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1421689035_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
</td>
</tr>
<tr>
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</div>
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</td>
</tr>
</tbody>
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</div>
</div>
<br>
 <div class=3D"m_848427763299318076ss-form-question m_848427763299318076errorbox-good">
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<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_2064050596">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA M=C3=A1ximo</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<table border=3D"0" cellpadding=3D"5" cellspacing=3D"0" id=3D"m_848427763299318076entry_1244707512">
<tbody>
<tr>
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</td>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_3" style=3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_1244707512_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
</td>
</tr>
<tr>
<td class=3D"m_848427763299318076ss-scalerow m_848427763299318076ss-leftlabel" style=3D"text-align:right;color:#666;border:1px solid #d3d8d3;border-left:0;border-right:0;padding:.5em .25em;padding-left:0">
<div class=3D"m_848427763299318076aria-todo">
</div>
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</div>
</td>
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</div>
</td>
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</div>
</td>
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</div>
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</div>
</td>
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</td>
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<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA M=C3=ADnimo</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
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<table border=3D"0" cellpadding=3D"5" cellspacing=3D"0" id=3D"m_848427763299318076entry_853118630">
<tbody>
<tr>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
</td>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_3" style=3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
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<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
 <td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_848427763299318076ss-scalenumber" for=3D"m_848427763299318076group_853118630_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_848427763299318076ss-scalenumbers" style=3D"text-align:center">
</td>
</tr>
<tr>
<td class=3D"m_848427763299318076ss-scalerow m_848427763299318076ss-leftlabel" style=3D"text-align:right;color:#666;border:1px solid #d3d8d3;border-left:0;border-right:0;padding:.5em .25em;padding-left:0">
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</div>
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</div>
</td>
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</td>
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</div>
</td>
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</div>
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</div>
</td>
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</div>
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</div>
</td>
<td class=3D"m_848427763299318076ss-scalerow m_848427763299318076ss-rightlabel" style=3D"text-align:left;color:#666;border:1px solid #d3d8d3;border-left:0;border-right:0;padding:.5em .25em;padding-right:0">
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<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_2140974612">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Anamnesis/Evoluci=C3=B3n<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Visita realizada en conjunto con kinesiologo y psic=C3=B3loga.Paciente en buenas condiciones generales, orientado en tiempo y espacio, sentado en sill=C3=B3n de living, sin dolor aparente ni referido.conversador, cooperador y animado a recibir todo tipo de terapias.se agendan terapias kinesicas y psicologicas por el mes de marzo, se iran agendando paulatinamente seg=C3=BAn evoluci=C3=B3n del paciente.Refiere haber aumentado ingesta de l=C3=ADquidos lo que lo mantienen bien hidratado.Por indicaci=C3=B3n medica en visita anterior, se sugiri=C3=B3 la suspensi==C3=B3n del medicamento &quot;Losartan&quot; ya que se manten=C3=ADa con hipotension asintom=C3=A1tica, lo cual desde el d=C3=ADa de la visita a mejorado sus valores.=20se encontraba pendiente el resultado de examen sanguineo, el cual tiene los siguientes valores: HMCTO: 27,6% HB: 8.8g/dl.</div>
</div>
</div>
</div>
<br>
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<div dir=3D"auto" class=3D"m_848427763299318076ss-item m_848427763299318076ss-item-required m_848427763299318076ss-paragraph-text" style=3D"margin:12px 0">
<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_824006088">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Examen F=C3=ADsico<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_848427763299318076ss-q-text" dir=3D"auto" style=3D"background-color:#eee;max-width:90%;border:1px solid #c0c0c0;padding:5px;white-space:pre-wrap;color:#545454;width:70%">
Paciente con palidez persistente propia del paciente, piel tibia, turgente, sin lesiones.Extremidades superiores moviles, simetricas, con amplitud de movimientos conservados.Torax simetrico, pulmones  murmullo pulmonar presente, sin ruidos agregadosABO blando, depresible, indoloro a la palpacion, sin presencia de masas.Extremidades inferiores simetricas, inferior izquierda con presencia de edema ++ sin signos de TVP. inferior derecha con edema +, se siguiere elevaci==C3=B3n de extremidades durante el d=C3=ADa.Genitales indemnes, con presencia de sonda foley #18 de silicona conectada a bolsa recolectora con presencia de 50 ml de orina clara, transparente sin residuos. se encuentra fija, permeable con vigencia al dia 20-03-2019.al CSV.Sat 99%P/A 120/90Fc: 88 Lpm.</div>
</div>
</div>
</div>
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<div class=3D"m_848427763299318076ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_848427763299318076ss-q-item-label" for=3D"m_848427763299318076entry_1690694733">
<div class=3D"m_848427763299318076ss-q-title" style==3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Diagn=C3=B3stico<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
</label>
<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_848427763299318076ss-q-help m_848427763299318076ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
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ansiedad r/c terapias ofrecidas por equipo multidiciplinario m/ verbalmente por el paciente</div>
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Plan de Tratamiento e Indicaciones<label for=3D"m_848427763299318076itemView.getDomIdToLabel()">
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<span class=3D"m_848427763299318076ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
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visita domiciliaria por enfermera 1 vez por semana y sos.</div>
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Medicamentos Indicados</div>
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Fecha aproximada del Pr=C3=B3ximo Control con usted</div>
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D=C3=ADa</option>
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1</option>
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2</option>
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3</option>
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4</option>
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5</option>
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6</option>
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7</option>
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14</option>
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16</option>
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18</option>
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19</option>
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20</option>
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21</option>
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22</option>
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1911</option>
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1914</option>
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1920</option>
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1938</option>
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1941</option>
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1942</option>
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1943</option>
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1945</option>
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1946</option>
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1951</option>
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1952</option>
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1953</option>
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1956</option>
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1957</option>
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1959</option>
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1970</option>
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1971</option>
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1972</option>
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1973</option>
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1976</option>
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1977</option>
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1978</option>
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1979</option>
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1981</option>
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1982</option>
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1984</option>
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1985</option>
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1986</option>
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1987</option>
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1988</option>
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1989</option>
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1991</option>
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1992</option>
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1993</option>
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1994</option>
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1996</option>
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1998</option>
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1999</option>
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2000</option>
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2001</option>
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2002</option>
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2005</option>
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2007</option>
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2010</option>
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2011</option>
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2012</option>
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2013</option>
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2017</option>
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2018</option>
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2020</option>
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2021</option>
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2022</option>
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2023</option>
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2024</option>
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2025</option>
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2026</option>
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2027</option>
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2028</option>
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2029</option>
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2030</option>
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2031</option>
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2032</option>
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2033</option>
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2034</option>
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2035</option>
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2036</option>
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2037</option>
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2038</option>
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2039</option>
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2040</option>
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2041</option>
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2042</option>
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2043</option>
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2044</option>
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2045</option>
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2046</option>
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2047</option>
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2048</option>
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2049</option>
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2050</option>
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2051</option>
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2052</option>
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2053</option>
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2054</option>
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2055</option>
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2056</option>
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2057</option>
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2058</option>
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2059</option>
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2060</option>
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2061</option>
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2062</option>
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2063</option>
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2064</option>
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2065</option>
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2066</option>
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2067</option>
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2068</option>
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2069</option>
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<div class=3D"m_848427763299318076ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tratamiento Realizado (si corresponde)</div>
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</div>
</label>
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Derivaci=C3=B3n a otro Prestador Domiciliario</div>
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S=C3=B3lo llene esta secci=C3=B3n si es m=C3=A9dico y solicita la visita de otro prestador del equipo</div>
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ENFERMERA</span>
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TENS</span>
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NUTRICIONISTA</span>
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KINESIOLOGO</span>
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PSICOLOGO</span>
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</h2>
<div style=3D"text-align:right">
<img class=3D"m_848427763299318076ss-image" title=3D"" src=3D"https://lh6.googleusercontent.com/ho5-aEhqapElKPfY3C043hrFRDZHbYmYQL4MdTOUr9VmGAzMIk1T6XQ9jJN3CuGBWoqcxaMG3A" style=3D"width:78px;outline:none" alt=3D"Imagen sin leyenda">
</div>
</div>
</div>
</div>
<br>
</form>
</div>
</div>
</td>
</tr>
<tr height=3D"24px">
</tr>
</tbody>
</table>
</div>
<table align=3D"center" cellpadding=3D"0" cellspacing=3D"0" style=3D"max-width:672px;min-width:154px" width=3D"100%">
<tbody>
<tr height=3D"24px">
<td>
</td>
</tr>
<tr>
<td>
<a href=3D"https://docs.google.com/forms?usp=3Dmail_form_link" style=3D"color:#424242;font-size:13px" target=3D"_blank">
Crea tu propio formulario de Google</a>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
<br clear=3D"all">
<div>
<br>
</div>
-- <br>
<div dir=3D"ltr" class=3D"gmail_signature" data-smartmail=3D"gmail_signature">
<div dir=3D"ltr">
<div>
<div dir=3D"ltr">
<div>
<div dir=3D"ltr">
<b>
<font color=3D"#3366ff">
Gabriela Martinez Tejeda</font>
</b>
</div>
<div dir=3D"ltr">
<font color=3D"#3366ff">
<b>
Enfermera</b>
</font>
</div>
<div dir=3D"ltr">
<font color=3D"#3366ff">
<b>
+56996101087<br>
</b>
</font>
<div>
<br>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
</div>
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