Äîäàòîê 5

äî Íàêàçó ÌÎÇ ¹

                                                                                                         â³ä               2008 ð.

 

 

ÇÐÀÇÎÊ ÔÎÐÌÈ  ÏÐÎÒÎÊÎËÓ ÏÎIJÉÍÎÃÎ ×ÈÒÀÍÍß ÖÈÔÐÎÂÈÕ ÌÀÌÎÃÐÀÔ²×ÍÈÕ ÇÎÁÐÀÆÅÍÜ

 

Øòàìï ë³êóâàëüíî-                                          ²äåíòèô³êàö³éíèé íîìåð ÐÌÖ:

ïðîô³ëàêòèíîãî                                                          ÕÕ1ZZ

çàêëàäó

 

ÏÐÎÒÎÊÎË 004-110108

ïîäâ³éíîãî ÷èòàííÿ öèôðîâèõ ìàìîãðàô³÷íèõ çîáðàæåíü

 

Íîìåð äîñë³äæåííÿ

Ï.².Á

гê

íàðîäæåííÿ

Ïåðøå ÷èòàííÿ

Äðóãå ÷èòàííÿ

Êîä âèñíîâêó

000150

ÊÀÐÏÎÂÀ Ò.Ì.

1947

N

N

N

000151

ÏÅÒÐÎÂÀ Â.Î.

1942

N

N

N

000152

ÊÐÈËÎÂÀ Î.Î.

1947

N

LL

LL

000153

ÏÀÍÔÈËÎÂÀ Ã.Ñ.

1946

N

N

N

000154

ÎÐËÎÂÀ Ê.Â.

1954

N

N

N

000155

ÌÀÑËÎÂÀ Ñ.Ñ.

1950

N

N

N

000156

²ÂÀÍÎÂÀ Î.².

1957

RP

RP

RP

..................

......................................

.....................

...............

................

...............

000189

ÊÐÀÑÍÎÂÀ Ã.Ô.

1952

N

N

N

 

 

 

ϳäïèñ

    1-ãî  

   ë³êàðÿ

ϳäïèñ

   2-ãî                     

  ë³êàðÿ

ϳäïèñè

  îáîõ

 ë³êàð³â

 

Ï.².Á. ðåíòãåíîëîã³â:  1-å ÷èòàííÿ   Ïåòðîâ ².².           (ï³äïèñ)

                                    2-å ÷èòàííÿ   Ôîìèí Ï.Ï.          (ï³äïèñ)