Ichki ishlar vazirligining
2000-yil 18-dekabrdagi
260-sonli buyrug‘iga
2-ilova
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Mahkumlarning tibbiy tekshiruvdan o‘tganligi haqida Maxsus tibbiy komissiya | |
Ismi, sharifi ____________________________________________________________________________________________ | |
Tug‘ilgan yili va joyi ___________________________________________________________________________ | |
___________________________________________________________________________________________ | |
Kim tomonidan va qachon hukm qilingan _______________________________________________________________ | |
____________________________________________________________________________________________ | |
O‘zR JK ____________________ moddasi Jazo muddati __________________________________ Muddat boshlangan vaqt _______________________ Muddatning tugash vaqti _________________ Shaxsiy hujjatlarning yig‘ma jildi__________________________________________________ Sudlanguncha kim bo‘lib ishlagan _____________________________________________________ | |
(ishlamagan bo‘lsa sababi ko‘rsatilsin) | |
Jazo muddatini o‘tash davrida kasal bo‘lguncha kim bo‘lib ishlagan _____________________________________________ | |
(ishlamagan bo‘lsa sababi ko‘rsatilsin) | |
Sog‘ligiga shikoyatlar ____________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
Anamnez | |
Hayoti davomida qanday kasalliklarga chalingan va qayerda davolangan _________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
Qanday jarohatlar olgan va operatsiya bo‘lgan ____________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
Asosiy kasalliklarning boshlanishi va kechishi, asosiy kasalliklari bo‘yicha qayerda va qancha vaqt davolangan, o‘tkazilgan davolash muolajalari _________________________________________________________________________________ | |
Obyektiv tekshirish ma’lumotlari | |
1. Bo‘yi________sm. Vazni___________kg. | |
2. Tana terisi va shilliq pard�si holati _______________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
3. Muskul va suyak tizimi, bo‘g‘inlar holati _____________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
4. Nafas olish a’zolari __________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
5. Yurak, qon-tomir a’zolari_______________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
6. Ovqat xazm qilish a’zolari_______________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
7. Siydik yo‘llari va jinsiy a’zolar tizimi____________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
8. Asab tizimi va ruhiy holati _____________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
9. Ko‘rish holati _________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
10. Quloq, tomoq va burun a’zolari holati ____________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
11. Rentgen tekshiruvi natijalari ___________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
12. Laboratoriya tekshiruvlari natijalari ____________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
13. Yakuniy tashxis ________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ | |
O‘zbekiston Respublikasi Sog‘liqni saqlash va Ichki ishlar vazirligi tomonidan tasdiqlangan va O‘zbekiston Respublikasi Ichki ishlar vazirligining 2000-yil “18” dekabr dagi 260 —sonli buyrug‘i bilan e’lon qilingan, Mahkumlarni kasalligi tufayli jazo muddati o‘tashdan ozod qilish uchun asos bo‘ladigan Kasalliklar Ro‘yxatining ____________bandiga asosan Mahkum________________________________________________________________________ | |
(familiyasi, ismi, sharifi) | |
jazo muddatini o‘tashdan ozod qilishga tavsiya etilishi mumkin. | |
| _______________(F.I.Sh.) _______________(F.I.Sh.) _______________(F.I.Sh.) _______________(F.I.Sh.) 200_yil “___” __________ ___________ (F.I.Sh.) 200_yil “___”____________ |
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Tartib | Familiyasi, ismi sharifi, tug‘ilgan yili, O‘zR JK moddasi, jazo muddati va boshlangan sana | Bemor kasalxonaga kelgan sana va qanday tashxis bilan yuborilgan | Bemor kasalxonada tekshirilgandan so‘ng qo‘yilgan va maxsus tibbiy komissiya ko‘rigiga taqdim etilgan tashxis, sana | Maxsus tibbiy Komissiya majlisi o‘tgan sana va qabul qilingan qaror | Muassasa ma’muriyati hujjatlarni sudga yuborgan sana | Sud majlisi bo‘lgan sana, sud chiqargan qaror | Izoh (sud ozod etgan sana, sud kunigacha yetmay vafot etgan sana, sud rad etgandai so‘ng vafot etgan sana, hujjatlari qaytadan sudga taqdim etilgan sana) tagiga chizilsin. |
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Ichki ishlar vazirligining 2000-yil
18-dekabrdagi 260-sonli
buyrug‘iga 5-ilova
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Muassasa turining kodi _____________________ IIV,IIBB,IIB,JIEBB | |
_________________________________________ muassasa Tibbiyot bo‘limi (maxfiylik belgisi) xizmati kodi______________________________ _________________________________________ | |
(hisobotni qabul qiluvchi idora nomi) | |
Kim tomonidan taqdim etiladi ______________ ________________________________________ |
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(IIV.JIEBB, IIBB,IIB nomi) ________________________________________ (hisobotni yuboruvchi muassasa nomi) | |
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