<div dir=3D"auto">
<div class=3D"gmail_quote" dir=3D"auto">
<div dir=3D"ltr">
<br>
</div>
<blockquote class=3D"gmail_quote" style=3D"margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div class=3D"gmail_extra">
<div class=3D"gmail_quote">
<blockquote class=3D"m_-3345048170570193944quote" style=3D"margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div>
<br>
Natalia Ibar Navarrete<br>
Nutricionista Universidad Cat=C3=B3lica del Maule<br>
+569 66235457<br>
<a href=3D"mailto:naty_ibar@live.cl" target=3D"_blank" rel=3D"noreferrer">
naty_ibar@live.cl</a>
<br>
<hr style=3D"display:inline-block;width:98%">
<div dir=3D"ltr">
<font face=3D"Calibri, sans-serif" style=3D"font-size:11pt" color=3D"#000000">
<b>
De:</b>
 Formularios de Google &lt;<a href=3D"mailto:forms-receipts-noreply@google.com" target=3D"_blank" rel=3D"noreferrer">
forms-receipts-noreply@google.com</a>
&gt;<br>
<b>
Enviado:</b>
 viernes, 3 de mayo de 2019 17:39:01<br>
<b>
Para:</b>
 <a href=3D"mailto:naty_ibar@live.cl" target=3D"_blank" rel=3D"noreferrer">
naty_ibar@live.cl</a>
<br>
<b>
Asunto:</b>
 Registro de Atenci=C3=B3n Domiciliaria Oncovida</font>
<div>
=C2=A0</div>
</div>
<div style=3D"font-family:&#39;roboto&#39;,&#39;helvetica&#39;,&#39;arial&#39;,sans-serif;margin:0;padding:0;height:100%;width:100%">
<table border=3D"0" cellpadding=3D"0" cellspacing=3D"0" width=3D"100%" style=3D"background-color:rgb(38,4,154)">
<tbody>
<tr>
<td style=3D"padding-left:24px">
<img alt=3D"Formularios de Google" height=3D"26px" width=3D"143px" style=3D"display:inline-block;margin:0;vertical-align:middle" 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" width=3D"100%" style=3D"background-color:#fff">
<tbody>
<tr>
<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" rel=3D"noreferrer">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</a>
</div>
</td>
</tr>
<tr>
</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>
<div>
<h1 dir=3D"ltr" style=3D"margin:0.67em 0">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</h1>
<div 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>
<form method=3D"GET" target=3D"_blank">
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Direcci=C3=B3n de correo electr=C3=B3nico <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
</label>
<div 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:naty_ibar@live.cl" target=3D"_blank" rel=3D"noreferrer">
naty_ibar@live.cl</a>
</div>
</div>
</div>
</div>
<div>
<div dir=3D"auto" style=3D"margin:12px 0;max-width:100%">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
</h2>
<div style=3D"text-align:right">
<img alt=3D"Imagen sin leyenda" style=3D"width:78px;outline:none" src=3D"https://lh4.googleusercontent.com/7WxFGV5oEKKf6rzNb0Iw8YpwJxhebvN37sfEgvirGhVlOohE3P9pNEU3e4QpKhgH1mM-c1xwGQ">
</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Prestador</h2>
<div 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>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Primer Nombre y Apellido Paterno <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
</div>
</label>
<div 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%">
Natalia ibar</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
RUT <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
RUT con Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: 5632200-k)</div>
</label>
<div 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%">
19008596-1</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Tipo <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 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"x_entry.133691676" disabled>
<option value=3D"">
</option>
<option value=3D"MEDICO" disabled>
MEDICO</option>
<option value=3D"ENFERMERA/O" disabled>
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 selected>
NUTRICIONISTA</option>
</select>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0;max-width:100%">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
</h2>
<div style=3D"text-align:right">
<img alt=3D"Imagen sin leyenda" style=3D"width:78px;outline:none" src=3D"https://lh4.googleusercontent.com/3_W3VwwMo1GiMEhNrv87B57PDW8BccI5mhSfE6p-lSCi4ennEWvZyCNRVNh9IS3zA_JNCIBLbA">
</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Paciente</h2>
<div 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>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 style=3D"background-color:#eee;padding:0.4em">
Datos Personales del Paciente</h2>
<div style=3D"margin-top:0.5em;white-space:pre-wrap;word-wrap:break-word">
</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Ingrese el Rut del Paciente <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
RUT con Gui=C3=B3n y D=C3=ADgito Verificador, sin puntos ( Ej: 5632200-k)</div>
</label>
<div 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%">
5356383-k</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Ingrese el Primer Nombre y Apellido Paterno del Paciente <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
</div>
</label>
<div 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%">
Laura garcia</div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Previsi=C3=B3n <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
</div>
</label>
<select name=3D"x_entry.545002227" disabled>
<option value=3D"">
</option>
<option value=3D"BANMEDICA" disabled>
BANMEDICA</option>
<option value=3D"CAPREDENA" disabled>
CAPREDENA</option>
<option value=3D"COLMENA" disabled>
COLMENA</option>
<option value=3D"CONSALUD" disabled selected>
CONSALUD</option>
<option value=3D"CRUZ BLANCA" disabled>
CRUZ BLANCA</option>
<option value=3D"DIPRECA" disabled>
DIPRECA</option>
<option value=3D"FONASA" disabled>
FONASA</option>
<option value=3D"FUNDACION" disabled>
FUNDACION</option>
<option value=3D"ISAPRES DEL COBRE" disabled>
ISAPRES DEL COBRE</option>
<option value=3D"NUEVA MASVIDA" disabled>
NUEVA MASVIDA</option>
<option value=3D"VIDATRES" disabled>
VIDATRES</option>
<option value=3D"PARTICULAR" disabled>
PARTICULAR</option>
</select>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Ciudad <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
</div>
</label>
<div 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%">
Los niches </div>
</div>
</div>
</div>
<br>
<div>
<div dir=3D"auto" style=3D"margin:12px 0">
<div style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label>
<div style=3D"display:block;font-weight:bold;margin-top:0.83em;margin-bottom:0.83em">
Comuna <label>
</label>
<span style=3D"color:#c43b1d">
*</span>
</div>
<div dir=3D"auto" style=3D"display:block;margin:0.1em 0 0.25em 0;color:#666">
</div>
</label>
<div dir=3D"auto">
</div>
</div>
</div>
</div>
</form>
</div>
</div>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
</div>
</blockquote>
</div>
<br>
</div>
</blockquote>
</div>
</div>
--000000000000f839fb058802f3ed--