PRELIMINAR TESTICULAR

NOMBRE: _Angel L. Matos Gonzalez______________________ MRN/ID #: _______________________

FECHA: ____12-13-2016+____ F.N.: ___________________ EDAD: ___35____

GENERO: _X_ M ___F

ALTURA: _____510______ PESO: ____250_____LBS

HISTORIAL:____________________________________________________________________________
DIAGNOSTICO: ________________________________________________________________________
CIRUGIAS PREVIAS / BIOPSIAS: ____________________________________________________________
DR. QUE LO REFIERE: ___________________________ SONOGRAFISTA: __________________________

RIGHT TESTICLE:

LEFT TESTICLE:

LONG: ___________

LONG: ___3.9CM________

TRVS: ____________

TRVS: ____2.9CM________

AP: ______________

AP: _____1,7CM_________

EPIDIDIMUS HEAD:

EPIDIDIMUS HEAD:

LONG: ___________

LONG: _____1.4CM______

TRVS: ____________

TRVS: ____________

AP: ______________

AP: ______________

HALLAZGOS:
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