<div dir=3D"ltr">
<br>
<br>
<div class=3D"gmail_quote">
<div dir=3D"ltr" class==3D"gmail_attr">
---------- Forwarded message ---------<br>
De: <strong class=3D"gmail_sendername" dir=3D"auto">
Google Forms</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: vie., 24 may. 2019 a las 23:16<br>
Subject: Registro de Atenci=C3=B3n Domiciliaria Oncovida<br>
To:  &lt;<a href=3D"mailto:claudio.ravi94@gmail.com">
claudio.ravi94@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"Google Forms" 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">
Thanks for filling out <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">
Here&#39;s what we got from you:</div>
</td>
</tr>
<tr>
<td>
<div class=3D"m_1603314414147567741ss-form-container">
<div class=3D"m_1603314414147567741ss-form-heading">
<h1 class=3D"m_1603314414147567741ss-form-title" dir=3D"ltr" style=3D"margin:.67em 0">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</h1>
<div class=3D"m_1603314414147567741ss-form-desc m_1603314414147567741ss-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_1603314414147567741ss-form">
<form method=3D"GET" id=3D"m_1603314414147567741ss-form" target=3D"_blank">
<br>
<div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741emailAddress">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Email address<label for=3D"m_1603314414147567741emailAddress">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
</label>
<div class=3D"m_1603314414147567741ss-q-text m_1603314414147567741ss-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:claudio.ravi94@gmail.com" target=3D"_blank">
claudio.ravi94@gmail.com</a>
</div>
</div>
</div>
</div>
<div class=3D"m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-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_1603314414147567741ss-image" title=3D"" src=3D"https://lh4.googleusercontent.com/7WxFGV5oEKKf6rzNb0Iw8YpwJxhebvN37sfEgvirGhVlOohE3P9pNEU3e4QpKhgH1mM-c1xwGQ" style=3D"width:78px;outline:none" alt=3D"Captionless Image">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Prestador</h2>
<div class=3D"m_1603314414147567741ss-page-description m_1603314414147567741ss-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_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_579114469">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Primer Nombre y Apellido Paterno<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_1603314414147567741ss-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%">
Claudio Ram=C3=ADrez</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_1276273985">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
RUT<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-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_1603314414147567741ss-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%">
18502492-k</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-select" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_133691676">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-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_1603314414147567741entry_133691676">
<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 selected>
PSICOLOGO</option>
 <option value==3D"NUTRICIONISTA" disabled>
NUTRICIONISTA</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-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_1603314414147567741ss-image" title=3D"" src=3D"https://lh4.googleusercontent.com/3_W3VwwMo1GiMEhNrv87B57PDW8BccI5mhSfE6p-lSCi4ennEWvZyCNRVNh9IS3zA_JNCIBLbA" style=3D"width:78px;outline:none" alt=3D"Captionless Image">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Paciente</h2>
<div class=3D"m_1603314414147567741ss-page-description m_1603314414147567741ss-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_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-section-header" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-section-title" style=3D"background-color:#eee;padding:0.4em">
Datos Personales del Paciente</h2>
<div class=3D"m_1603314414147567741ss-section-description m_1603314414147567741ss-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_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_823811303">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Rut del Paciente<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-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_1603314414147567741ss-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%">
7966839-7</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_1959365839">
<div class=3D"m_1603314414147567741ss-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_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_1603314414147567741ss-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%">
Jose Leiva</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-select" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_545002227">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Previsi=C3=B3n<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-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_1603314414147567741entry_545002227">
<option value=3D"">
</option>
<option value=3D"BANMEDICA" disabled>
BANMEDICA</option>
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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>
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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_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_1900161356">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ciudad<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_1603314414147567741ss-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%">
Antofagasta</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-text" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_1298871758">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Comuna<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_1603314414147567741ss-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%">
Antofagasta</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-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_1603314414147567741ss-image" title=3D"" src=3D"https://lh3.googleusercontent.com/a--QM0tHOY2N-ywEy9inrBWw-4f6j9Ofzul9VQSNQn1ad8mPRl1_kCJQR9ynQdP2swvENM5UdQ" style=3D"width:78px;outline:none" alt=3D"Captionless Image">
</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_1603314414147567741ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Registro de la Atenci=C3=B3n Domiciliaria</h2>
<div class=3D"m_1603314414147567741ss-page-description m_1603314414147567741ss-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_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-radio" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_2073233714">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo de Atenci=C3=B3n<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<ul class=3D"m_1603314414147567741ss-choices" style=3D"list-style:none;padding:0;margin:.5em 0 0">
<li class=3D"m_1603314414147567741ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_1603314414147567741ss-choice-item-control m_1603314414147567741goog-inline-block" style=3D"display:inline-block">
<input type==3D"radio" name=3D"entry.1222378237" disabled checked value=3D"Domicilio" id=3D"m_1603314414147567741group_1222378237_1" class=3D"m_1603314414147567741ss-q-radio">
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<span class=3D"m_1603314414147567741ss-choice-label">
Domicilio</span>
</label>
</li>
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<label>
<span class=3D"m_1603314414147567741ss-choice-item-control m_1603314414147567741goog-inline-block" style=3D"display:inline-block">
<input type==3D"radio" name=3D"entry.1222378237" disabled value=3D"Ambulatorio" id=3D"m_1603314414147567741group_1222378237_2" class=3D"m_1603314414147567741ss-q-radio">
</span>
<span class=3D"m_1603314414147567741ss-choice-label">
Ambulatorio</span>
</label>
</li>
</ul>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-date" style=3D"margin:12px 0">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_1705849412">
<div class=3D"m_1603314414147567741ss-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_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_1603314414147567741ss-q-date">
<div class=3D"m_1603314414147567741ss-datetime-box m_1603314414147567741goog-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"">
Month</option>
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January</option>
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February</option>
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March</option>
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April</option>
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May</option>
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June</option>
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July</option>
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August</option>
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September</option>
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October</option>
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November</option>
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December</option>
</select>
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<option value=3D"">
Day</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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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>
=20<select name=3D"entry.1705849412_year" disabled id=3D"m_1603314414147567741entry.1705849412_year">
<option value=3D"">
Year</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>
 <option value=3D"1979">
1979</option>
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1980</option>
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1981</option>
 <option value==3D"1982">
1982</option>
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1983</option>
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1984</option>
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1985</option>
 <option value==3D"1986">
1986</option>
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1987</option>
 <option value==3D"1988">
1988</option>
 <option value=3D"1989">
1989</option>
 <option value==3D"1990">
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>
 <option value==3D"2018">
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>
 <option value==3D"2064">
2064</option>
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2065</option>
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2066</option>
 <option value=3D"2067">
2067</option>
 <option value==3D"2068">
2068</option>
 <option value=3D"2069">
2069</option>
</select>
</div>
</div>
</div>
</div>
</div>
<br>
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<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-item-required m_1603314414147567741ss-time" style=3D"margin:12px 0;font:inherit">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_206244955">
<div class=3D"m_1603314414147567741ss-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_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_1603314414147567741ss-q-time">
<div class=3D"m_1603314414147567741ss-datetime-box m_1603314414147567741goog-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_1603314414147567741entry.206244955_hour">
<option value=3D"">
Hr</option>
<option value=3D"01">
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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<option value=3D"">
Min</option>
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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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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>
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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>
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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>
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46</option>
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47</option>
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48</option>
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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>
 <option value=3D"54">
54</option>
 <option value=3D"55">
55</option>
 <option value=3D"56">
56</option>
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57</option>
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58</option>
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59</option>
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AM</option>
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PM</option>
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</div>
</div>
</div>
</div>
</div>
<br>
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<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Performance Status ECOG del Paciente<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
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</div>
</label>
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</option>
<option value=3D"0" disabled>
0</option>
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1</option>
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2</option>
 <option value=3D"3" disabled>
3</option>
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4</option>
</select>
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</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
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<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_1716090865">
<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA Actual</div>
<div class=3D"m_1603314414147567741ss-q-help m_1603314414147567741ss-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_1603314414147567741entry_1421689035">
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<tr>
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</td>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_3" style=3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1421689035_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
</td>
</tr>
<tr>
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<div class=3D"m_1603314414147567741aria-todo">
</div>
</td>
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</td>
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</div>
</td>
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</div>
</td>
<td class=3D"m_1603314414147567741ss-scalerow m_1603314414147567741ss-rightlabel" style=3D"text-align:left;color:#666;border:1px solid #d3d8d3;border-left:0;border-right:0;padding:.5em .25em;padding-right:0">
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
<br>
 <div class=3D"m_1603314414147567741ss-form-question m_1603314414147567741errorbox-good">
<div dir=3D"auto" class=3D"m_1603314414147567741ss-item m_1603314414147567741ss-scale" style=3D"margin:12px 0;overflow-x:auto">
<div class=3D"m_1603314414147567741ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_1603314414147567741ss-q-item-label" for=3D"m_1603314414147567741entry_2064050596">
<div class=3D"m_1603314414147567741ss-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_1603314414147567741ss-q-help m_1603314414147567741ss-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_1603314414147567741entry_1244707512">
<tbody>
<tr>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
</td>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_3" style=3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
 <td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_1244707512_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
</td>
</tr>
<tr>
<td class=3D"m_1603314414147567741ss-scalerow m_1603314414147567741ss-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_1603314414147567741aria-todo">
</div>
</td>
<td class=3D"m_1603314414147567741ss-scalerow" style=3D"text-align:center;color:#666;border:1px solid #d3d8d3;border-left:0;border-right:0;padding:.5em .25em">
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<input type=3D"radio" name=3D"entry.1244707512" disabled value=3D"0" id=3D"m_1603314414147567741group_1244707512_1" class=3D"m_1603314414147567741ss-q-radio">
</div>
</td>
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<input type=3D"radio" name=3D"entry.1244707512" disabled value=3D"1" id=3D"m_1603314414147567741group_1244707512_2" class=3D"m_1603314414147567741ss-q-radio">
</div>
</td>
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</div>
</td>
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Escala Dolor EVA M=C3=ADnimo</div>
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</div>
</label>
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</td>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
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1</label>
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2</label>
</td>
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3</label>
</td>
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<label class==3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_7" style=3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_9" style==3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
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<label class=3D"m_1603314414147567741ss-scalenumber" for=3D"m_1603314414147567741group_853118630_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_1603314414147567741ss-scalenumbers" style=3D"text-align:center">
</td>
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<tr>
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</div>
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</div>
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Anamnesis/Evoluci=C3=B3n<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
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*</span>
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</div>
</label>
<div class=3D"m_1603314414147567741ss-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%">
El paciente se encuentra bastante bien en t=C3=A9rminos generales, a diferencia de la sesi=C3=B3n anterior en la cual manifestaba cierta molestia a nivel general producto de el aumento de la dosis del parche intra dermis, lo cual no se sabia en ese momento. En esta sesi=C3=B3n esas molestias desaparecieron, ya que se volvi=C3=B3 a la dosis anterior. Adem=C3=A1s Don Jos=C3=A9 manifiesta poder haber vuelto a sentir el sabor de las comidas despu=C3=A9s de algunos d=C3=ADas.Una de las medidas mas importantes que tom=C3=B3 Don Jos=C3=A9 y su pareja, en funci=C3=B3n de que actualmente los dos se encuentra mejor de salud es poder realizar sus actividades de forma mas independiente, para que de esta forma no se saturen por estar tanto tiempo juntos. Adem=C3=A1s Don Jos=C3==A9 tomo la decisi=C3=B3n de apoyar a su se=C3=B1ora en este momento que ==C3=A9l se siente mejor, como una especie de vuelta de mano ya que ella ha tenido mucho desgaste en todo este proceso y =C3=A9l es consciente de eso.</div>
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<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Examen F=C3=ADsico<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
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*</span>
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</div>
</label>
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Todo dentro de los margenes esperados. No ha perdido cabello, buen apetito, no ha perdido peso (al contrario ha subido unos cuantos kilos).</div>
</div>
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</div>
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<div class=3D"m_1603314414147567741ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Diagn=C3=B3stico<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
<span class=3D"m_1603314414147567741ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
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</div>
</label>
<div class=3D"m_1603314414147567741ss-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%">
C=C3=A1ncer de pr=C3=B3stata</div>
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Plan de Tratamiento e Indicaciones<label for=3D"m_1603314414147567741itemView.getDomIdToLabel()">
</label>
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Preparaci=C3=B3n para afrontar el proceso en funci=C3=B3n de visualizar todas las probabilidades en cuanto a que el paciente pueda colocarse en cada una de las situaciones posibles. Especial =C3=A9nfasis en las sesiones de quimio terapia que quedan, que lo m=C3==A1s probable sean las m=C3=A1s aversivas.</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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Tratamiento Realizado (si corresponde)</div>
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Continuar el monitoreo respecto a que el paciente pueda retomar sus acciones cotidianas de forma paulatina, poniendo especial cuidado en que siga al pie de la letra las indicaciones de reposo y evitar hacer fuerza brusca entre otros.</div>
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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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</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">
Create your own Google Form</a>
</td>
</tr>
</tbody>
</table>
</div>
</div>
</div>
</div>
<div id=3D"DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2">
<br>
 <table style=3D"border-top:1px solid #d3d4de">
	<tr>
      <td style=3D"width:55px;padding-top:18px">
<a href=3D"http://www.avg.com/email-signature?utm_medium=3Demail&amp;utm_source=3Dlink&amp;utm_campaign=3Dsig-email&amp;utm_content=3Dwebmail" target=3D"_blank">
<img src=3D"https://ipmcdn.avast.com/images/icons/icon-envelope-tick-green-avg-v1.png" alt==3D"" width=3D"46" height=3D"29" style=3D"width: 46px; height: 29px;">
</a>
</td>
		<td style=3D"width:470px;padding-top:17px;color:#41424e;font-size:13px;font-family:Arial,Helvetica,sans-serif;line-height:18px">
Libre de virus. <a href=3D"http://www.avg.com/email-signature?utm_medium=3Demail&amp;utm_source=3Dlink&amp;utm_campaign=3Dsig-email&amp;utm_content=3Dwebmail" target=3D"_blank" style=3D"color:#4453ea">
www.avg.com</a>
 		</td>
	</tr>
</table>
<a href=3D"#DAB4FAD8-2DD7-40BB-A1B8-4E2AA1F9FDF2" width=3D"1" height=3D"1">
</a>
</div>
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