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the Appendix

The appendix.

CARD of survey of an oral cavity of the teenager.

The code number _____________

№ _______________

1.familija, a name, a patronymic ____________________________________________

2.

Age (full is not present) ____________________________________________________

3. __________________________________________________________________ address

(A city, rajvoenkomat)

4. An occupation ____________________________________________________________

(A trade, a place of work, study)

5. The transferred diseases _______________________________________________

6. Whether there is a stomatologic office or unit at establishment where studies or works examined (yes, is not present) __________________________________

Whether 7.0бращался within a year behind the stomatologic help (yes, is not present) _____

In ! 1
8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8
n 1

і AT sh _ | p і і p sh jy _
! і '

№№ 1 Maintenance of a designation The conditional
p/p Designations
1. Caries TO
2. The complicated caries which is subject to treatment L
The complicated caries which is subject to excision (the blasted tooth, the roots which are subject to excision ABOUT
4. The sealed up tooth P
5. Remote tooth AT
6. Not cut teeth np
7. Traumatic damage of a tooth t
8. Paradontosis (to specify degree - easy, average, serious) pd
9. Hypoplasia g
10. Fluorosis F
11. Crown KR
12. Intermediate part of a bridge-like prosthesis (over each replaced tooth) M
13. Tooth in a demountable prosthesis With



9.3убочслюстные anomalies (yes, is not present) _____

(Anomalies of position, density a supercomplete teeth) a diastema, tremy, an adentia,

10. Anomaly of an occlusion (yes, is not present) ________________________________________

(Deep, prognatija, a progeny, opened) 11. Whether requires prosthetics at date of survey (yes, is not present) _________ _____

12. Additional data

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200 years the Doctor

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A source: Semenchenko Elena Gennadevna. Socio-hygienic study of the dental health of adolescents as the basis for the organization of comprehensive recreational activities at the primary care level Thesis for the degree of candidate of medical sciences. Moscow - 200. 2006

More on topic the Appendix:

  1. the Appendix
  2. the Appendix 4
  3. the Appendix
  4. THE APPENDIX
  5. the Appendix
  6. THE APPENDIX
  7. the APPENDIX 4
  8. the Appendix
  9. the Appendix
  10. the Appendix
  11. THE APPENDIX
  12. the Appendix
  13. THE APPENDIX
  14. the Appendix
  15. the Appendix
  16. the Appendix In
  17. THE APPENDIX
  18. THE APPENDIX
  19. THE APPENDIX
  20. the Appendix 3.