标题: [原创]patient's information (新病人信息表)--中英文对照 [打印本页] 作者: 岐黄术 时间: 2003-5-31 22:05 标题: [原创]patient's information (新病人信息表)--中英文对照 [这个贴子最后由岐黄术在 2003/06/16 01:21pm 第 2 次编辑]
Name (last, first) 名字(姓，名) ___________________________
Occupation 职业_____________________________________________________
Main reason(s) for seeking treatment?
主要要治疗什么病?
How long have you experienced symptoms?
病情出现多久了?
Your condition is improved by…
什么情况下会觉得好一点(即病情会改善) ?
Your condition is aggravated by…
什么情况下情况恶化?
Age年龄___________________________
Do you have high blood pressure or are you on blood pressure medications? YES NO
有无高血压或治疗?(有/没有)
Significant illnesses (please check all that apply)
主要疾病(选出合适的)
o Cancer(癌症)
o Diabetes(糖尿病)
o Hepatitis(肝炎)
o Heart Disease(心脏病)
o Stroke(中风)
o Seizures(癫痫 epilepsy ?)
o HIV / Aids(艾滋病)
o Pneumonia(肺炎)
o Tuberculosis(肺结核)
o Multiple sclerosis(各种硬化,如血管)
o Thyroid diseases(甲状腺疾病,如hyperthyroidism 甲亢 )
o Asthma (哮喘)
o Stomach Ulcers (胃溃疡)
o Obesity (肥胖)
o Depression (抑郁症)
o Shingles (带状疱疹)
o Chronic Fatigue (这个不太清楚是什么,可能是慢性消耗性疾病 wasting disease?)
o Rheumatic Fever (风湿热)
For the next three choices, please list details on lines below
(以下三个选项,请列出详情)
o Surgery (date and type)外科手术(时间,类型--)
o Major Trauma (emotional or accidental: describe) 创伤(情志上或偶发, 详情)
o Allergies – please list 过敏—请列出
Emotional stress scale (please circle)
情绪压抑指数(请圈出)
1 2 3 4 5 6 7 8 9 10
no stress moderate extremely stressed
没有压抑 中等 特别