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FECHA SESION N

FICHA CLINICA | FLORES DE BACH NIOS

Nombre ____________________________________________________________________

Edad _________ Ocupacin ________________________________________________

TRATAMIENTOS ACTUALES y/o ANTERIORES

Mdico Psicolgico Psiquitrico Med. Comp. Otro Ninguno

Diagnstico _____________________________________ Duracin ____________________

MOTIVO DE CONSULTA

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APUNTES | VERBALIZACIONES | OBSERVACIONES

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FECHA SESION N

RECETA

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DOSIS _______________________________________________________________________

OBSERVACIONES

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RECETA ADULTOS

A.01 A.02

DOSIS _______________________________________________________________________

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