（第次入院）姓名：科别：儿科床号：住院号姓名：XXX职业：性别：X工作单位：年龄：XX住址：XXXXXXX婚姻：XX供史者：XXX（与患者关系）出生地：XX入院时间：XXXX年X月X日X时X分民族：X族记录时间：XXXX年X月X日X时X分主诉：XXXXXXXXXXXXXX现病史：XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX。既往史：XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX。
