<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">
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: jue., 11 abr. 2019 a las 0:19<br>
Subject: Registro de Atenci=C3=B3n Domiciliaria Oncovida<br>
To:  &lt;<a href=3D"mailto:javieraleal.95@gmail.com">
javieraleal.95@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_-6070272698024853256ss-form-container">
<div class=3D"m_-6070272698024853256ss-form-heading">
<h1 class=3D"m_-6070272698024853256ss-form-title" dir=3D"ltr" style=3D"margin:.67em 0">
Registro de Atenci==C3=B3n Domiciliaria Oncovida</h1>
<div class=3D"m_-6070272698024853256ss-form-desc m_-6070272698024853256ss-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_-6070272698024853256ss-form">
<form method=3D"GET" id=3D"m_-6070272698024853256ss-form" target=3D"_blank">
<br>
<div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256emailAddress">
<div class=3D"m_-6070272698024853256ss-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_-6070272698024853256emailAddress">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
</label>
<div class=3D"m_-6070272698024853256ss-q-text m_-6070272698024853256ss-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:javieraleal.95@gmail.com" target=3D"_blank">
javieraleal.95@gmail.com</a>
</div>
</div>
</div>
</div>
<div class=3D"m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-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_-6070272698024853256ss-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_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Prestador</h2>
<div class=3D"m_-6070272698024853256ss-page-description m_-6070272698024853256ss-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_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_579114469">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Primer Nombre y Apellido Paterno<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6070272698024853256ss-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%">
Javiera Leal</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_1276273985">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
RUT<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-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_-6070272698024853256ss-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%">
18965132-5</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-select" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_133691676">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-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_-6070272698024853256entry_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>
PSICOLOGO</option>
 <option value=3D"NUTRICIONISTA" disabled selected>
NUTRICIONISTA</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-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_-6070272698024853256ss-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_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Paciente</h2>
<div class=3D"m_-6070272698024853256ss-page-description m_-6070272698024853256ss-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_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-section-header" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-section-title" style=3D"background-color:#eee;padding:0.4em">
Datos Personales del Paciente</h2>
<div class=3D"m_-6070272698024853256ss-section-description m_-6070272698024853256ss-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_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_823811303">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Rut del Paciente<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-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_-6070272698024853256ss-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%">
3602556-5</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_1959365839">
<div class=3D"m_-6070272698024853256ss-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_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6070272698024853256ss-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%">
Maria Romero </div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-select" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_545002227">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Previsi=C3=B3n<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-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_-6070272698024853256entry_545002227">
<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 class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_1900161356">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ciudad<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6070272698024853256ss-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%">
Concepci=C3=B3n</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_1298871758">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Comuna<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6070272698024853256ss-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%">
Concepci=C3=B3n</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-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_-6070272698024853256ss-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_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6070272698024853256ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Registro de la Atenci=C3=B3n Domiciliaria</h2>
<div class=3D"m_-6070272698024853256ss-page-description m_-6070272698024853256ss-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_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-radio" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_2073233714">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo de Atenci=C3=B3n<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<ul class=3D"m_-6070272698024853256ss-choices" style=3D"list-style:none;padding:0;margin:.5em 0 0">
<li class=3D"m_-6070272698024853256ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_-6070272698024853256ss-choice-item-control m_-6070272698024853256goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled checked value=3D"Domicilio" id=3D"m_-6070272698024853256group_1222378237_1" class=3D"m_-6070272698024853256ss-q-radio">
</span>
<span class=3D"m_-6070272698024853256ss-choice-label">
Domicilio</span>
</label>
</li>
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<label>
<span class=3D"m_-6070272698024853256ss-choice-item-control m_-6070272698024853256goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled value=3D"Ambulatorio" id=3D"m_-6070272698024853256group_1222378237_2" class=3D"m_-6070272698024853256ss-q-radio">
</span>
<span class=3D"m_-6070272698024853256ss-choice-label">
Ambulatorio</span>
</label>
</li>
</ul>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-date" style=3D"margin:12px 0">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_1705849412">
<div class=3D"m_-6070272698024853256ss-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_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6070272698024853256ss-q-date">
<div class=3D"m_-6070272698024853256ss-datetime-box m_-6070272698024853256goog-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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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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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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<option value=3D"">
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>
</select>
=20<select name=3D"entry.1705849412_year" disabled id=3D"m_-6070272698024853256entry.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>
 <option value==3D"2000">
2000</option>
 <option value=3D"2001">
2001</option>
 <option value==3D"2002">
2002</option>
 <option value=3D"2003">
2003</option>
 <option value==3D"2004">
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>
 <option value==3D"2046">
2046</option>
 <option value=3D"2047">
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>
 <option value==3D"2056">
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_-6070272698024853256ss-form-question m_-6070272698024853256errorbox-good">
<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-item-required m_-6070272698024853256ss-time" style=3D"margin:12px 0;font:inherit">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_206244955">
<div class=3D"m_-6070272698024853256ss-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_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6070272698024853256ss-q-time">
<div class=3D"m_-6070272698024853256ss-datetime-box m_-6070272698024853256goog-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_-6070272698024853256entry.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>
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:<select name=3D"entry.206244955_minute" disabled id=3D"m_-6070272698024853256entry.206244955_minute">
<option value=3D"">
min</option>
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00</option>
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01</option>
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56</option>
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58</option>
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<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Performance Status ECOG del Paciente<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6070272698024853256ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
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</div>
</label>
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0</option>
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1</option>
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2</option>
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<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-scale" style=3D"margin:12px 0;overflow-x:auto">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_1716090865">
<div class=3D"m_-6070272698024853256ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
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<div class=3D"m_-6070272698024853256ss-q-help m_-6070272698024853256ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
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</td>
<td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_3" style==3D"display:block;padding:0.5em 0 .5em">
2</label>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_7" style==3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1421689035_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
</td>
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<input type=3D"radio" name=3D"entry.1421689035" disabled value=3D"9" id=3D"m_-6070272698024853256group_1421689035_10" class=3D"m_-6070272698024853256ss-q-radio">
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<input type=3D"radio" name=3D"entry.1421689035" disabled value=3D"10" id=3D"m_-6070272698024853256group_1421689035_11" class=3D"m_-6070272698024853256ss-q-radio">
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</td>
</tr>
</tbody>
</table>
</div>
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</div>
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<div dir=3D"auto" class=3D"m_-6070272698024853256ss-item m_-6070272698024853256ss-scale" style=3D"margin:12px 0;overflow-x:auto">
<div class=3D"m_-6070272698024853256ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6070272698024853256ss-q-item-label" for=3D"m_-6070272698024853256entry_2064050596">
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</label>
<table border=3D"0" cellpadding=3D"5" cellspacing=3D"0" id=3D"m_-6070272698024853256entry_1244707512">
<tbody>
<tr>
<td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
</td>
<td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_3" style==3D"display:block;padding:0.5em 0 .5em">
2</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_4" style=3D"display:block;padding:0.5em 0 .5em">
3</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_5" style=3D"display:block;padding:0.5em 0 .5em">
4</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style==3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_6" style=3D"display:block;padding:0.5em 0 .5em">
5</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_7" style==3D"display:block;padding:0.5em 0 .5em">
6</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_8" style=3D"display:block;padding:0.5em 0 .5em">
7</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_9" style=3D"display:block;padding:0.5em 0 .5em">
8</label>
</td>
 <td class=3D"m_-6070272698024853256ss-scalenumbers" style==3D"text-align:center">
<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_10" style=3D"display:block;padding:0.5em 0 .5em">
9</label>
</td>
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<label class=3D"m_-6070272698024853256ss-scalenumber" for=3D"m_-6070272698024853256group_1244707512_11" style=3D"display:block;padding:0.5em 0 .5em">
10</label>
</td>
<td class=3D"m_-6070272698024853256ss-scalenumbers" style=3D"text-align:center">
</td>
</tr>
<tr>
<td class=3D"m_-6070272698024853256ss-scalerow m_-6070272698024853256ss-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_-6070272698024853256aria-todo">
</div>
</td>
<td class=3D"m_-6070272698024853256ss-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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</div>
</td>
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<div class=3D"m_-6070272698024853256ss-scalerow-fieldcell">
<input type=3D"radio" name=3D"entry.1244707512" disabled value=3D"1" id=3D"m_-6070272698024853256group_1244707512_2" class=3D"m_-6070272698024853256ss-q-radio">
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Escala Dolor EVA M=C3=ADnimo</div>
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0</label>
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Se realiza evaluaci=C3=B3n nutricional en Home Care, ubicado en calle Sanhueza #104 Av. Pedro de valdivia. Al momento de la visita la paciente se encuentra  con una amiga y compa=C3=B1era de habitaci=C3=B3n.Historia clinicaPaciente con antecedentes de ca renal, hipertensi=C3=B3n arterial, fibrilaci=C3=B3n auricular, usuaria de marcapaso bicameral, hipoacusia derecha, usuaria de aud=C3=ADfono derecho.Refiere estar durmiendo bien pero sentirse desanimada desde que lleg=C3=B3 de la cl=C3=ADnica, y tener miedo de realizar sus deposiciones, enfermera comenta que el dia 09/abril tuvo deposiciones (+) blandas.Intolerancias alimentarias: NoAlergias: NoApetito:  Refiere no tener apetito pero comerse toda la comida=20Recordatorio 24 horas:Desayuno (9.00am): 1 taza de t=C3=A9 con endulzante + 1 rebanada de pan molde con mermelada sin az=C3=BAcar y 1 rebanada con mermelada diet=20Almuerzo (12.30) Ensalada de tomate ( 2 unidades)(con aceite y sal) + 1 Trozo de pescado frito  con pur=C3=A9 + Jalea diet.Once: (16.00) 1 taza de t=C3=A9 con endulzante + 1 rebanada de pan molde con mermelada sin az=C3=BAcar y 1 rebanada con mermelada diet=20Cena (19.00) sopa crema de verduras con pollo + 1 gelatina dietRefiere que en ocasiones familiares le llevan dulces, queque, que come durante la tarde.=20Aporte total d=C3=ADa: 1389 kcal, 60,3g prote=C3=ADnas, CHO 212g, L=C3=ADpidos 31gRequerimiento:  1960 Kcal, 56 g prote=C3=ADnas, CHO 294g, L=C3=ADpidos 63gAdecuaci=C3=B3n:        70% kcal, 107% prote=C3=ADnas, 71% CHO,  46% l=C3==ADpidosEncuesta tendencia de consumo:=20Frutas: 3/7Cereales: 3/7Pan: 2 unidades/d=C3=ADaVerduras: 7/7aceite: 7/7L=C3=A1cteos: 4/7Legumbres: 1/7Huevo: 2/7Pescado: 2/7Agua total dia: 1400cc aprox.</div>
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Examen F=C3=ADsico<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
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PA: 127/86=20FC. 86Piel P=C3=A1lida, sana, mucosas hidratadas, escleras rosadas, con edema en extremidades inferiores +=C2=B4+ + , abdomen indoloro, diuresis (+), Deposiciones *(+ para el dia 09/04) higiene general bien conservada.</div>
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Diagn=C3=B3stico<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
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*</span>
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Dg Nutricional: Paciente adulta mayor con estado nutricional normal en el l=C3=ADmite inferior, con compartimentos muscular y graso disminuidos. Presenta insuficiencia alimentaria en calor=C3=ADas, carbohidratos y l=C3=ADpidos.</div>
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Plan de Tratamiento e Indicaciones<label for=3D"m_-6070272698024853256itemView.getDomIdToLabel()">
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Peso: 63kgPeso ajustado: 56kgPeso Minimo: 53kgAltura: 1.50mIMC: 24,8kg/m2Requerimiento :=201960kcal/ d=C3=ADa, 56g/d=C3=ADa prote=C3=ADnas, CHO 294g/d=C3=ADa, Lipidos 63g/d=C3=ADaPrescripci=C3=B3n diet=C3=A9tica: R=C3=A9gimen blando hipercal=C3=B3rico, hipos=C3=B3dico, con restricci=C3=B3n de l=C3=ADquidos, horarios fraccionados.Indicaciones:Realizar caminatas durante el d=C3=ADa, dentro de lo que ella pueda tolerarRestringir consumo de agua a 800 cc consumo libre + 400 cc de t=C3=A9Aumentar el consumo de frutas (cocidas)Realizar preparaciones con ensure distintas a la leche, para aumentar su tolerancia=20Comer en peque=C3=B1as cantidades pero varias veces al d=C3=ADa para aumentar su ingesta total/d=C3=ADaPersonal de home care van a registrar la ingesta de las preparaciones durante la semana para ver real consumo y aporte total.</div>
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Medicamentos Indicados</div>
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1)	Buprenorfina 35ug, =C2=BD parche cada 3,5 d=C3=ADas2)	Paracetamol 500mg/8hrs vo3)	Tramadol 10 gotas vo SOS4)	Bisoprolol 1,25mg/d=C3=ADa vo5)	Olmesart=C3=A1n 40mg/d=C3=ADa vo6)	Levotiroxina 25ug/d=C3=ADa vo (al menos media hr antes del desayuno y 1 hrs antes del omeprazol)7)	Ciprofloxacino 500mg/12hrs vo hasta completar 5 d=C3=ADas (hoy d=C3=ADa 3/5)8)	Omeprazol 20mg/12hrs vo hasta terminar uso de antibi=C3=B3tico, luego suspender9)	Escitalopran 5mg/d=C3=ADa vo10)	Quetiapina 12,5mg/noche vo11)	Furosemida 40mg/d=C3=ADa vo12)	Vitamina C, 1 comp efervescente al d=C3=ADa vo13)	Centrum silver 1 comp/d=C3=ADa vo14)	Lactulosa jarabe, 10-30cc/6-8hrs, lo necesario para 2-3 deposiciones semiformadas al d=C3=ADa (se educa a EU del centro de residencia)15)	Slow K 1 comp/8hrs x3 d=C3=ADas, luego 1comp/12hrsx3 d=C3=ADas, luego 1 comp/d=C3=ADa hasta finalizar caja, vo=20</div>
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Fecha aproximada del Pr=C3=B3ximo Control con usted</div>
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<div class=3D"m_-6070272698024853256ss-datetime-box m_-6070272698024853256goog-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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D==C3=ADa</option>
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1</option>
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2</option>
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18</option>
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31</option>
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Mes</option>
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A=C3=B1o</option>
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2017</option>
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2018</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>
</div>
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Tratamiento Realizado (si corresponde)</div>
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</div>
</label>
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Se realiz=C3=B3 evaluaci=C3=B3n Nutricional integral con control de peso y descuento por edema (peso aproximado), ademas de evaluaci=C3=B3n de sus compartimentos muscular y graso. Encuestas alimentaria recordatorio 24hrs y tendencia de consumo. Se educa sobre consumo de l=C3=A1cteos, frutas, verduras y agua. Se conversa otras maneras de consumo de ensure ya que refiere no tolerarlo, por lo que se sugiere cambiar por ensure polvo. Se sugiere realizar un registro durante la semana sobre el consumo de alimentos. </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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ENFERMERA</span>
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