中医病院出院评价表(国外英文资料).doc

中医医院入院评估表 Central hospital admission evaluation form Dont bed, hospital, record time The name National vocational education age and gender Marital status: married and divorced widowed religious beliefs: there is no native place Hospitalization time was associated with the onset of morbidity Contact telephone with work unit or address Admission diagnosis: western medicine of traditional Chinese medicine Admission cause: main complaint + brief illness (the cause of this disease + main symptom) : History of allergies: no (drugs, food) A, four examination: temperature pulse blood pressure breathing weight (1) observation: Look at god: there is a feeling of boredom and lethargy Complexion: ruddy and red, red and yellow, pale, yellow and dull Form: normal walk difficulty half does not have to be able to lie other Form: normal fat wastes other Sentiment: a sunny worry is a pessimist Skin: complete and rupture of the other Breath: even a breath of air and breath Cough: no more (phlegm thin yellow sputum white sticky sputum volume Other) Lichen: thin white thin yellow moss white moss Tongue: pale red and white and red purple (2) listening and smelling Voice: normal voice moaned and groaning and low breathing Breath: always, breath, and slow breathing Cough: no: no sputum has sputum (white, yellow, red, rust) (more, medium, less) quality (clear, thick) Smell: odorless, rancid, and other (3) the physician visits Perception: the numbing part of the pain: the onset of a property Thirst: thirst quench thirst not want to drink other Hearing: normal decline deafness (right left) Vision: normal loss of vision (right left) Sleep: the night dream is difficult to wake up early and wake up other medications Diet: the appetite: the Chinese food is like a constant to stay hungry not to want to eat and then to be bloated and greasy Defecate: normal secret to make the asphalt to release other Urination: normal urine carries blood and incontinence incontinence (4) pulse feeling and palpatio