<div dir=3D"ltr">
Estimados, junto con saludar, adjunto mi informe de 1=C2==B0visita a Sra. Marlene Rosas Olate, realizada el 6/6/19.=C2=A0<div>
atte.==C2=A0</div>
<div>
Viviana Zevallos Ananias</div>
<div>
Enfermera<br>
<br>
<div class=3D"gmail_quote">
<div dir=3D"ltr" class=3D"gmail_attr">
---------- Forwarded message ---------<br>
From: <strong class=3D"gmail_sendername" dir=3D"auto">
Formularios de Google</strong>
 <span dir=3D"auto">
&lt;<a href=3D"mailto:forms-receipts-noreply@google.com">
forms-receipts-noreply@google.com</a>
&gt;</span>
<br>
Date: Fri, Jun 7, 2019 at 4:18 AM<br>
Subject: Registro de Atenci=C3=B3n Domiciliaria Oncovida<br>
To:  &lt;<a href=3D"mailto:vivianazevallos@gmail.com">
vivianazevallos@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_-6592810309039478708ss-form-container">
<div class=3D"m_-6592810309039478708ss-form-heading">
<h1 class=3D"m_-6592810309039478708ss-form-title" dir=3D"ltr" style=3D"margin:.67em 0">
Registro de Atenci=C3=B3n Domiciliaria Oncovida</h1>
<div class=3D"m_-6592810309039478708ss-form-desc m_-6592810309039478708ss-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_-6592810309039478708ss-form">
<form method=3D"GET" id=3D"m_-6592810309039478708ss-form" target=3D"_blank">
<br>
<div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708emailAddress">
<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708emailAddress">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
</label>
<div class=3D"m_-6592810309039478708ss-q-text m_-6592810309039478708ss-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:vivianazevallos@gmail.com" target=3D"_blank">
vivianazevallos@gmail.com</a>
</div>
</div>
</div>
</div>
<div class=3D"m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-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_-6592810309039478708ss-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_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Prestador</h2>
<div class=3D"m_-6592810309039478708ss-page-description m_-6592810309039478708ss-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_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_579114469">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Primer Nombre y Apellido Paterno<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6592810309039478708ss-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%">
Viviana Zevallos</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_1276273985">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
RUT<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-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_-6592810309039478708ss-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%">
18413659-7</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-select" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_133691676">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-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_-6592810309039478708entry_133691676">
<option value=3D"">
</option>
<option value=3D"MEDICO" disabled>
MEDICO</option>
 <option value=3D"ENFERMERA/O" disabled selected>
ENFERMERA/O</option>
 <option value=3D"TENS" disabled>
TENS</option>
 <option value=3D"KINESIOLOGA/O" disabled>
KINESIOLOGA/O</option>
 <option value=3D"PSICOLOGO" disabled>
PSICOLOGO</option>
 <option value==3D"NUTRICIONISTA" disabled>
NUTRICIONISTA</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-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_-6592810309039478708ss-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_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Identificaci=C3=B3n del Paciente</h2>
<div class=3D"m_-6592810309039478708ss-page-description m_-6592810309039478708ss-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_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-section-header" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-section-title" style=3D"background-color:#eee;padding:0.4em">
Datos Personales del Paciente</h2>
<div class=3D"m_-6592810309039478708ss-section-description m_-6592810309039478708ss-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_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_823811303">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ingrese el Rut del Paciente<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-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_-6592810309039478708ss-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%">
14369376-7</div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_1959365839">
<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6592810309039478708ss-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%">
Marlene Rosas </div>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-select" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_545002227">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Previsi=C3=B3n<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-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_-6592810309039478708entry_545002227">
<option value=3D"">
</option>
<option value=3D"BANMEDICA" disabled>
BANMEDICA</option>
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CAPREDENA</option>
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COLMENA</option>
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CONSALUD</option>
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CRUZ BLANCA</option>
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DIPRECA</option>
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FONASA</option>
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FUNDACION</option>
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ISAPRES DEL COBRE</option>
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NUEVA MASVIDA</option>
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VIDATRES</option>
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PARTICULAR</option>
</select>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_1900161356">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Ciudad<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-text" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_1298871758">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Comuna<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-embeddable-object-container" style=3D"margin:12px 0;max-width:100%">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-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_-6592810309039478708ss-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_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-page-break" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<h2 class=3D"m_-6592810309039478708ss-page-title" style=3D"padding:0.4em;background-color:#eee">
Registro de la Atenci=C3=B3n Domiciliaria</h2>
<div class=3D"m_-6592810309039478708ss-page-description m_-6592810309039478708ss-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_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-radio" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_2073233714">
<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Tipo de Atenci=C3=B3n<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<ul class=3D"m_-6592810309039478708ss-choices" style=3D"list-style:none;padding:0;margin:.5em 0 0">
<li class=3D"m_-6592810309039478708ss-choice-item" style=3D"margin:0;line-height:1.3em;padding-bottom:.5em">
<label>
<span class=3D"m_-6592810309039478708ss-choice-item-control m_-6592810309039478708goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled checked value=3D"Domicilio" id=3D"m_-6592810309039478708group_1222378237_1" class=3D"m_-6592810309039478708ss-q-radio">
</span>
<span class=3D"m_-6592810309039478708ss-choice-label">
Domicilio</span>
</label>
</li>
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<label>
<span class=3D"m_-6592810309039478708ss-choice-item-control m_-6592810309039478708goog-inline-block" style=3D"display:inline-block">
<input type=3D"radio" name=3D"entry.1222378237" disabled value=3D"Ambulatorio" id=3D"m_-6592810309039478708group_1222378237_2" class=3D"m_-6592810309039478708ss-q-radio">
</span>
<span class=3D"m_-6592810309039478708ss-choice-label">
Ambulatorio</span>
</label>
</li>
</ul>
</div>
</div>
</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-date" style=3D"margin:12px 0">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_1705849412">
<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6592810309039478708ss-q-date">
<div class=3D"m_-6592810309039478708ss-datetime-box m_-6592810309039478708goog-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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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>
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Mes</option>
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enero</option>
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febrero</option>
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marzo</option>
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abril</option>
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mayo</option>
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junio</option>
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julio</option>
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agosto</option>
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septiembre</option>
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octubre</option>
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noviembre</option>
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diciembre</option>
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=20<select name=3D"entry.1705849412_year" disabled id=3D"m_-6592810309039478708entry.1705849412_year">
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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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1923</option>
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1924</option>
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1925</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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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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1940</option>
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1943</option>
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1946</option>
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1947</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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1975</option>
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1976</option>
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1979</option>
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1981</option>
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1982</option>
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1983</option>
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1984</option>
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1985</option>
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1986</option>
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1987</option>
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1988</option>
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1989</option>
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1990</option>
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1991</option>
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1992</option>
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1993</option>
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1994</option>
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1995</option>
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1996</option>
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1997</option>
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1998</option>
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1999</option>
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2000</option>
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2001</option>
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2002</option>
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2003</option>
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2004</option>
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2005</option>
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2006</option>
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2007</option>
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2008</option>
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2009</option>
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2010</option>
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2011</option>
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2012</option>
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2013</option>
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2014</option>
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2015</option>
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2016</option>
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2017</option>
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2018</option>
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2019</option>
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2020</option>
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2021</option>
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2022</option>
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2023</option>
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2024</option>
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2025</option>
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2026</option>
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2027</option>
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2028</option>
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2029</option>
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2030</option>
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2031</option>
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2032</option>
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2033</option>
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2034</option>
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2035</option>
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2036</option>
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2037</option>
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2038</option>
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2039</option>
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2040</option>
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2041</option>
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2042</option>
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2043</option>
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2044</option>
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2045</option>
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2046</option>
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2047</option>
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2048</option>
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2049</option>
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2050</option>
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2051</option>
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2052</option>
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2053</option>
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2054</option>
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2055</option>
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2056</option>
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2057</option>
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2058</option>
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2059</option>
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2060</option>
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2061</option>
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2062</option>
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2063</option>
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2064</option>
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2065</option>
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2066</option>
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2067</option>
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2068</option>
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2069</option>
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</div>
</div>
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</div>
<br>
 <div class=3D"m_-6592810309039478708ss-form-question m_-6592810309039478708errorbox-good">
<div dir=3D"auto" class=3D"m_-6592810309039478708ss-item m_-6592810309039478708ss-item-required m_-6592810309039478708ss-time" style=3D"margin:12px 0;font:inherit">
<div class=3D"m_-6592810309039478708ss-form-entry" style=3D"margin-bottom:1.5em;vertical-align:middle;margin-left:0;margin-top:0;max-width:100%">
<label class=3D"m_-6592810309039478708ss-q-item-label" for=3D"m_-6592810309039478708entry_206244955">
<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708itemView.getDomIdToLabel()">
</label>
<span class=3D"m_-6592810309039478708ss-required-asterisk" style=3D"color:#c43b1d">
*</span>
</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
</div>
</label>
<div class=3D"m_-6592810309039478708ss-q-time">
<div class=3D"m_-6592810309039478708ss-datetime-box m_-6592810309039478708goog-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_-6592810309039478708entry.206244955_hour">
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h</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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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_-6592810309039478708entry.206244955_minute">
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min</option>
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00</option>
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01</option>
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Performance Status ECOG del Paciente<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
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<div class=3D"m_-6592810309039478708ss-q-title" style=3D"display:block;font-weight:bold;margin-top:.83em;margin-bottom:.83em">
Escala Dolor EVA Actual</div>
<div class=3D"m_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
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0</label>
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3</label>
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5</label>
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6</label>
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8</label>
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9</label>
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10</label>
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<div class=3D"m_-6592810309039478708ss-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_-6592810309039478708ss-q-help m_-6592810309039478708ss-secondary-text" dir=3D"auto" style=3D"display:block;margin:.1em 0 .25em 0;color:#666">
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</td>
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<label class=3D"m_-6592810309039478708ss-scalenumber" for=3D"m_-6592810309039478708group_1244707512_1" style=3D"display:block;padding:0.5em 0 .5em">
0</label>
</td>
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<label class=3D"m_-6592810309039478708ss-scalenumber" for=3D"m_-6592810309039478708group_1244707512_2" style=3D"display:block;padding:0.5em 0 .5em">
1</label>
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2</label>
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3</label>
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4</label>
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5</label>
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<label class=3D"m_-6592810309039478708ss-scalenumber" for=3D"m_-6592810309039478708group_1244707512_7" style==3D"display:block;padding:0.5em 0 .5em">
6</label>
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7</label>
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8</label>
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9</label>
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10</label>
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</td>
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Paciente de 45 a=C3=B1os, recibe 1=C2=B0 visita de ingreso de m=C3=A9dico y enfermera de equipo de cuidados paliativos Telemed. De profesi=C3=B3n tecn=C3=B3logo m=C3=A9dico, vive con sus dos hijos, de 19 y 12 a=C3=B1os, refiere no tener m=C3=A1s familia en Concepci=C3=B3n.=20Diagosticada de CaCu grado 1 el a=C3=B1o 2015.=20El d=C3=ADa de visita, paciente no cuenta con registro de tratamiento, por encontrarse todos los informes en Santiago. Sin embargo, refiere que proceso de enfermedad inicia con un PAP anormal en 2015, que mostraba lesi=C3=B3n en cuello uterino, posiblemente ectropio. Es derivada a ginec=C3=B3logo, quien realiza crioterapia, provocando hemorragia durante procedimiento. Por esto, m=C3=A9dico solicita examen de colposcop=C3=ADa, la cual no mostr=C3==B3 lesi=C3=B3n posterior. Paciente decide solicitar segunda opini=C3=B3n con m=C3=A9dico en Centro Cl=C3=ADnico PUC Santiago, quien solicita Biopsia, la cual indic=C3=B3 presencia de tejido maligno en cuello uterino. Por ello, se realiza histerectom=C3=ADa total y linfadenectom=C3=ADa inguinal izquierda. Su caso es evaluado por comit=C3=A9 m=C3=A9dico, quien indica evaluaci=C3=B3n cada seis meses, no se indica quimioterapia ni radioterapia.  Posteriormente, hubo recidiva de sintomatolog=C3=ADa con sangrado, por lo cual se indic=C3=B3 quimioterapia y radioterapia.=20Es dada de alta en septiembre de 2016, con dichas evaluaciones peri=C3=B3dicas, y retoma actividad  laboral.=20En enero de 2018, paciente presenta cuadros de dolor repetitivos en zona tor=C3=A1cica, irradiado a zona vertebral pero m=C3=A9dico solicita TAC de abdomen y pelvis de control. Paciente solicita realizar Radiograf=C3=ADa de t=C3=B3rax, la que mostr=C3=B3 masa en pulm=C3=B3n. Ex=C3=A1menes posteriores mostraron malignidad, sugerente de met=C3=A1stasis, por lo cual se le indica quimioterapia sist=C3=A9mica, con cisplatino y radiocirug=C3=ADa. Posterior TAC indica disminuci=C3=B3n del tama=C3=B1o de tumor.=20En marzo de 2018, paciente refiere a m=C3=A9dico recidiva de dolor, irradiado a mama izquierda. M=C3=A9dico la deriva a anestesista para bloqueo de nervio perif=C3=A9rico para tratamiento de dolor, considerado neurop=C3=A1tico. Anestesista solicita cintigrama =C3=B3seo, el cual evidencia lesi=C3=B3n =C3=B3sea, atribuible a radioterapia. Se realiza TAC de t=C3=B3rax, que muestra que tumor irradiado hab=C3=ADa recuperado su tama=C3=B1o original, invadiendo tejidos de cavidad tor=C3=A1cica.=20Paciente cambia de prestadores por t=C3=A9rmino de seguro, y es derivada al IRAM, tambi=C3=A9n en Santiago. En IRAM m=C3=A9dico indica 20 sesiones de radioterapia, que finalizaron la semana pasada.=20Debido a la progresi=C3=B3n de la lesi=C3=B3n pulmonar posterior al primer tratamiento, paciente estuvo en evaluaci=C3=B3n para neumonectom=C3=ADa o inmunoterapia. Ante lo invasivo de la cirug=C3=ADa, paciente acuerda iniciar inmunoterapia.=20Anamnesis actual:=20Al momento de visita, paciente se encuentra en regulares condiciones generales, de regular estado de =C3=A1nimo, tranquila, cooperadora, Glasgow 15, notable caquexia. Se encuentra acompa=C3=B1ada de ambos hijos, quienes no participan de visita. Autovalente, deambulaci=C3=B3n espont=C3=A1nea, sin ayuda, con supervisi=C3=B3n.Usuaria de Metadona c/8 hr, Morfina sos, Prednisona y lasoprazol. Adem=C3==A1s, consume FitLine 2 veces x d=C3=ADa. No presenta dolor al momento de visita, refiere solamente molestias en mama izquierda.=20Alimentaci=C3=B3n bien tolerada, actualmente tolera bien desayuno y once (pan, jam=C3=B3n, palta y t=C3=A9), y almuerzo, con un plato fuerte m=C3=A1s ensalada. Se ha mantenido sin v=C3=B3mitos, sin n=C3=A1useas, sin diarrea, deposiciones dif=C3=ADciles 1 vez c/2 d=C3=ADas. Hidrataci=C3=B3n de aprox dos litros por d=C3=ADa (t=C3=A9, agua), bien tolerada. Orina clara, frecuente, sin alteraciones referidas.=20Mantiene buen descanso, con 5 horas de sue=C3=B1o nocturno como m=C3=ADnimo m=C3=A1s siestas diurnas. Refiere diaforesis nocturna. Pese a descaso, manifiesta sentirse cansada tanto f=C3=ADsica como psicol=C3=B3gicamente.=20Actualmente contin=C3=BAa siendo atendida en Santiago, donde se queda en casa de amigos, quienes tambi=C3=A9n la ayudan en lo necesario. Reside en Concepci=C3=B3n con sus dos hijos, quienes conocen diagn=C3=B3stico pero conocen poco del proceso y progresi=C3=B3n de enfermedad de la sra Marlene.=20</div>
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Examen F=C3=ADsico<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
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Ciclo vital: Normoc=C3=A1rdica, normotensa, afebril, eupneica, saturando 98 % a Fio2 ambiental.=20Piel y mucosas indemnes, p=C3=A1lida, caqu=C3=A9ctica, buena higiene general.=20Cabeza: normoc=C3=A9falo, isocoricas, reflejo fotomotor (+).=20Cuello sin adenopat=C3=ADas palpables.=20EESS: presentes, m=C3=B3viles, sin dolor, sin edema, sin lesiones.=20T=C3=B3rax: sim=C3=A9trico, ritmo cardiaco regular, murmullo pulmonar positivo, levemente disminuido en pulm=C3=B3n izquierdo, cat=C3=A9ter sucut=C3==A1neo con reservorio en zona sublavia derecha sin situ, funcional, sin dolor, piel circundante sana, sin hematoma ni equimosis, no se palpa crepitaci=C3=B3n subcut=C3=A1nea. Hiperpigmentaci=C3=B3n de piel en zona escapular derecha por radioterapia. No se observa radiodermitis.=20Abdomen blando, depresible, indoloro. Ruidos hidroa=C3=A9reos presentes.=20Extremidades: presentes, m=C3=B3viles, sin dolor, sin lesiones, linfedema secundario, grado 1, en extremidad inferior izquierda.=20Zona sacra/genital: sin alteraciones.=20</div>
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C=C3=A1ncer cervicouterino</div>
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Plan de Tratamiento e Indicaciones<label for=3D"m_-6592810309039478708itemView.getDomIdToLabel()">
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Ex=C3=A1menes de laboratorio: hemograma - VHP - hoja hep=C3=A1tica - Creatinina - uremia - perfil lip=C3=ADdico - TSH -  Glicemia.=20Evaluaci=C3=B3n nutricional  1 vez/semana=20Evaluaci=C3=B3n Psicol=C3=B3gica 1 vez / semana=20Evaluaci=C3=B3n m=C3=A9dica 1 vez/ semana=20Evaluaci=C3=B3n enfermera 1 vez x semana.=20Control urgencias sos=20Alimentaci=C3=B3n e hidrataci=C3=B3n a tolerancia=20</div>
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Medicamentos Indicados</div>
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Metadona 100 mg =C2=BC c/12 horas=20Pregabalina 75 mg 1 x noche.=20Morfina gotas 4 gotas sos oral=20Dexametasona 4 mg x d=C3=ADa=20Lansoprazol 30 mg 1 comp por d=C3=ADa </div>
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Fecha aproximada del Pr=C3=B3ximo Control con usted</div>
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2008</option>
 <option value=3D"2009">
2009</option>
 <option value==3D"2010">
2010</option>
 <option value=3D"2011">
2011</option>
 <option value==3D"2012">
2012</option>
 <option value=3D"2013">
2013</option>
 <option value==3D"2014">
2014</option>
 <option value=3D"2015">
2015</option>
 <option value==3D"2016">
2016</option>
 <option value=3D"2017">
2017</option>
 <option value==3D"2018">
2018</option>
 <option value=3D"2019" selected>
2019</option>
 <option value=3D"2020">
2020</option>
 <option value=3D"2021">
2021</option>
 <option value=3D"2022">
2022</option>
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2023</option>
 <option value=3D"2024">
2024</option>
 <option value=3D"2025">
2025</option>
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2026</option>
 <option value=3D"2027">
2027</option>
 <option value=3D"2028">
2028</option>
 <option value=3D"2029">
2029</option>
 <option value=3D"2030">
2030</option>
 <option value=3D"2031">
2031</option>
 <option value=3D"2032">
2032</option>
 <option value=3D"2033">
2033</option>
 <option value=3D"2034">
2034</option>
 <option value=3D"2035">
2035</option>
 <option value=3D"2036">
2036</option>
 <option value=3D"2037">
2037</option>
 <option value==3D"2038">
2038</option>
 <option value=3D"2039">
2039</option>
 <option value==3D"2040">
2040</option>
 <option value=3D"2041">
2041</option>
 <option value==3D"2042">
2042</option>
 <option value=3D"2043">
2043</option>
 <option value==3D"2044">
2044</option>
 <option value=3D"2045">
2045</option>
 <option value==3D"2046">
2046</option>
 <option value=3D"2047">
2047</option>
 <option value==3D"2048">
2048</option>
 <option value=3D"2049">
2049</option>
 <option value==3D"2050">
2050</option>
 <option value=3D"2051">
2051</option>
 <option value==3D"2052">
2052</option>
 <option value=3D"2053">
2053</option>
 <option value==3D"2054">
2054</option>
 <option value=3D"2055">
2055</option>
 <option value==3D"2056">
2056</option>
 <option value=3D"2057">
2057</option>
 <option value==3D"2058">
2058</option>
 <option value=3D"2059">
2059</option>
 <option value==3D"2060">
2060</option>
 <option value=3D"2061">
2061</option>
 <option value==3D"2062">
2062</option>
 <option value=3D"2063">
2063</option>
 <option value==3D"2064">
2064</option>
 <option value=3D"2065">
2065</option>
 <option value==3D"2066">
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>
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-Se recomienda alimentaci=C3=B3n e hidrataci=C3=B3n a tolerancia  -Se recomienda actividad f=C3=ADsica a tolerancia -Se recomienda evaluaci=C3=B3n de equipo multidisciplinario 2 vez por semana.  -Se educa sobre prevenci=C3=B3n de infecciones.  -Se recomienda expresi=C3=B3n de sentimientos y emociones.  -Se educa sobre el buen uso de sistemas de urgencias si hay signos de alarma.  -Se educa sobre modo de trabajo y coordinaci=C3=B3n de visitas de equipo Telemed e ISAPRE. </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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TENS</span>
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