Patient Details. Surgery Details. Surgeon's Notes to Surgery Theaters Sister. Accomodation Details. Pre Payment Details
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1 Patient Details Given Name Ανδρέας Middle Name Surname Ρούσος Gender M Date of Birth 12/12/1996 Age 19 Telephone Next of Kin Name Next of Kin Telephone Language (if not Greek or English) Surgery Details Doctor's Name MARIOS KARAISKAKIS Date of Surgery 29/03/2017 Surgery Other Surgery Body Side Not Applicable Surgery Details Περιτομή In / Out Patient Out Anesthesia Type General Preferred Start Time Expected Duration 1.00 hour(s) Anesthetist 1st choice ANDRIANI PHILIPPOU KONTOZI Anesthetist 2nd choice ANDREAS KOUREAS Assistant Doctor Surgeon's Notes to Surgery Theaters Sister Expected needs for Blood / Components: (If yes then please notify 48 hours before the scheduled surgery) Warnings (e.g., infections, allergies, pacemakers, anticoagulants) The patient must be at the Polyclinic before operation starts Implant Needs and Implant Manufacturer Implants to be purchased by the Polyclinic Doctor s notes to Sister No ΟΧΙ 1 hour οχι No / Not Applicable Accomodation Details For medical reasons the patient must stay in a room alone ICU Required? Patient s Preference No No Pre Payment Details Insurance ETHNIKI Pre payment for Polyclinic 0.00 Insurance Policy No.???
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