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| SURNAME | FIRSTNAME | GENDER | AGE | ADMISSION DIAGNOSIS | SURGICAL OR EMERGENCY INTERVENTIONS | Adm Date/from |
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| SHORT ANAMNESIS | saved items (money watch,..) | dental prothesis | orthopaedic prothesis | Diabetes? |
| Date | mentaly situation of the patient | mobilisation of the patient | oraly or parenteraly nutrition | output urine stool fluid bilance | Airways, I.V., urine katheters, Drainage | Sign |
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