Name | Sex | 肉末蒸水蛋Age | |||||
ID Card No. 长春特色小吃 | |||||||
Address | |||||||
Dept. | 鼻子上有黑头 Hospitalization No. | ||||||
Date of admission | Time of death | ||||||
Place of death | Hospital On the way to hospital At Home Others | ||||||
Diagnosis of death/Cau of death | |||||||
Managing physician: Date: | |||||||
Receiver: Relationship with the decead: Contact No.: | |||||||
If there is any objection to the cau of death of the patient, plea go through autopsy procedure within 24 hours after the patient’s death. The autopsy should be carried out within 48 hours after the patient’s death. | |||||||
| 入队 | |||||||
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