U.E.

404- HOSPITAL SAN JUAN DE DIOS DE PISCO

ECOGRAFÍA DE PARTES BLANDAS

PACIENTE…………………………………………………………………………………………………H.C.……………………………..
EDAD……………………………………………FECHA…………………………………………SERV:…………………………….……
MOTIVO DEL EXAMEN………………………………………………………………………………………………………………….
ZONA SOLICITADA:………………………………………………………………………………………………………………………..
El estudio ultrasonográfico evidencia:
1.-PIEL: Conservada ( ) SI ( ) NO
2.-TEJIDO CELULAR SUBCUTANEO:
Ecogenicidad: ( ) CONSERVADA ( ) INCREMENTADA
3.-DESCRIPCION:
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4.-CONCLUSION:
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