INTERCONSULTAS NEUROCIRURGIA
Formulário destinado a todos os setores do HGCA para solicitação de interconsultas para a Neurocirurgia
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Profissional Solicitante *
CREMEB *
Nome do Paciente *
Registro AGHUSE *
Leito *
Setor Solicitante *
Detalhe a solicitacão *
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