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Version 5.0 To be used for all acute stroke registrations from 1 January 2014 onwards. RIKS-STROKE - TIA Personal ID number
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Document Date: 2014-09-04 09:40:29

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Facility

Reporting hospital I___I___I___I Ward/department I___I___I___I Completed / hospital If / /

IndustryTerm

pharmaceuticals / /

MedicalCondition

transitory global amnesia / PLEASE USE SEPARATE FORM FOR ACUTE PHASE FOR REGISTRATION OF STROKE / I___I Auricular fibrillation / acute stroke / TIA/cerebral ischemia / dementia / cerebral infarction / atrial fibrillation / stroke / Previous stroke Previous TIA / Amaurosis / Diabetes / Auricular fibrillation / /

MedicalTreatment

naturopathy / /

Position

occupational therapist / physiotherapist / nurse / /

Product

Crestor / Clopidogrel / dipyridamole / Plavix / Lipitor / Pletal / Simvastatin / /

ProvinceOrState

I___I___I County / Connecticut / /

Technology

ultrasound / /

SocialTag