麻醉藥品、第一類精神藥品專用病歷

編號(hào)：藥物過(guò)敏史：****醫(yī)院麻醉藥品、第一類精神藥品專用病歷姓名：性別：年齡：身份證編號(hào)：工作單位：家庭住址：聯(lián)系電話：代辦人姓名：性別：年齡：身份證編號(hào)：聯(lián)系電話：注：此病歷由醫(yī)院保存就醫(yī)須知一、首次就診的患者須持有記錄診斷情況的原始病歷、二級(jí)以上醫(yī)院出具的診斷證明、患者本人戶籍簿、身份證及復(fù)印件到掛號(hào)室領(lǐng)取并辦理麻醉藥品、第一類精神藥品專用病歷。二、由他人代辦的除攜帶以上資料外，需另持代辦人身份證及復(fù)印件到掛號(hào)室領(lǐng)取并辦理麻醉藥品、第一類精神藥品專用病歷。三、患者診斷證明、身份證復(fù)印件及代辦人身份證復(fù)印件等留存在病歷當(dāng)中。四、患者每次就診持戶籍簿、身份證、原始病歷，到門診掛號(hào)后然后到指定科室就診。五、凡由他人代為辦理就診手續(xù)的，須攜帶患者戶籍簿、身份證、原始病歷、代辦人身份證到門診掛號(hào)后然后到指定科室就診。六、就診結(jié)束后，患者或代辦人持處方、病歷到門診辦理有關(guān)蓋章登記手續(xù)（付費(fèi)），藥房負(fù)責(zé)審核、發(fā)藥，對(duì)于不符合條件者，藥房有權(quán)拒絕發(fā)藥。病歷由藥房收回保管以備案。七、凡使用麻醉藥品、第一類精神藥品的患者必須簽署《麻醉藥品、第一類精神藥品使用知情同意書》。診療記錄_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________診療記錄_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________診療記錄_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________