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DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY

OUTPATIENT CLINIC 2017


Date:___________________________________
Consultant/Residents/Interns (sign above names): _____________________________________________________________________________________________________________

SERVICE HOSP NO PATIENTS NAME AGE ADDRESS CHIEF COMPLAINT FINAL ASSESSMENT/DIAGNOSIS MANAGEMENT/REMARKS
/SEX

*Write neatly and legibly at all times.

OPD
ENT.F.014
Issued: 03/09/17
Issue No. 001
DEPARTMENT OF OTORHINOLARYNGOLOGY-HEAD AND NECK SURGERY
OUTPATIENT CLINIC 2017
MF maxillofacial trauma, plastics and reconstructive surgery
RHI Rhinopharyngology
LBE laryngobronchoesophagology
OTO neuro-otology
HN head and neck surgery

OPD
ENT.F.014
Issued: 03/09/17
Issue No. 001

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