Приднестровский Государственный
Университет
им. Т.Г Шевченко
Аграрно-Технологический Факультет
Кафедра Клинических Ветеринарных
Дисциплин
ИСТОРИЯ БОЛЕЗНИ
Вид животного______________________пол_____________возраст__________________
Кличка_______________________________бирка__________________________________
Кому принадлежит____________________________________________________________
ДИАГНОЗ__________________________________________________________________
Дата поступления________________________Дата
выписки________________________
ИСХОД:____________________________________________________________________
Старший ветврач_____________________________________________
Куратор (Ф.И.О., группа, курс)__________________________________________________
Клиника________________________________
ИСТОРИЯ ЗАБОЛЕВАНИЯ
№___
I. ОБЩИЕ СВЕДЕНИЯ
Хозяйство или Ф.И.О. владельца животного________________________________________
Адрес____________________________________________________Телефон_____________
Паспортные сведения о животном: вид_____________пол____________возраст__________
Кличка, тавро, бирка№__________________________масть,приметы___________________
____________Порода, сорт____________________Вес__________Беременность_________
Дата поступления_____________________Исход
заболевания_________________________
Число дней лечения____________________________________________________________
Подпись врача (помощника куратора)_______________
II. АНАМНЕЗ
А) Анамнез об условиях содержания,
кормления, эксплуатации: ______________________
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Б) Анамнез о заболевании: (сведения
о перенесенных ранее заболеваниях;
санитарно-эпизоотическое состояние
хозяйства; история настоящего заболевания
– первоначальные симптомы, время
и обстоятельства их появления, первые
лечебные и профилактические меры, проведены
кем и когда): ___________________________________________________
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Подпись врача (куратора) _____________________________________
III. СОСТОЯНИЕ ЖИВОТНОГО ПРИ
ПОСТУПЛЕНИИ
“____”______________________ _______г.______________часов
Температура ______оС; Пульс_______уд/мин;
Дыхание _______движ/мин.
Габитус______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Упитанность__________________________________________________________________
Шерстный покров и кожа________________________________________________________
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Лимфоузлы_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Слизистые оболочки___________________________________________________________
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Органы кровообращения _______________________________________________________
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Органы дыхания_______________________________________________________________
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Органы пищеварения___________________________________________________________
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Молочная железа______________________________________________________________
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Мочеполовые органы__________________________________________________________
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Нервная система_______________________________________________________________
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Органы чувств________________________________________________________________
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Органы движения______________________________________________________________
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Status localis___________________________________________________________________
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ДОПОЛНИТЕЛЬНЫЕ ИССЛЕДОВАНИЯ
1. Рентгеновские, электрокардиографические
и др._________________________________
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