Êîìó____________________________________________________________________ ___ ÄÎÍÅÑÅÍÈÅ î ðåçóëüòàòàõ ñàíèòàðíî-ýïèäåìèîëîãè÷åñêîé ðàçâåäêè 1.Äàòà_________ , âðåìÿ_________ñèëàìè___________________________________________ ïðîâåäåíà ÑÝÐ__________________________________________________________________ ________________________________________________________________________ ________________________________(ÓÊÀÇÀÒÜ Ð-ÍÛ, ÌÀÐØÐÓÒÛ, ÍÀÑÅËÅÍÍÛÅ ÏÓÍÊÒÛ, Ð-ÍÛ ÒÏÓ,ÊÏ ÈÒÄ.)______ ________________________________________________________________________ ________ 2.Ñàíèòàðíî-ýïèäåìè÷åñêîå ñîñòîÿíèå(ÄÀÒÜ ÎÁÙÓÞ ÎÖÅÍÊÓ ÑÀÍ-ÝÏÈÄ. ÑÎÑÒÎßÍÈß Ð-ÍÀ, ÎÁÚ-ÅÊ- ÒÎÂ) ________________________________________________________________________ ____ ________________________________________________________________________ ________________________________________________________________________ ________________ ïî(ÓÊÀÇÀÒÜ ÏÎ ÊÀÊÈÌ ÍÎÇÎËÎÃÈ×ÅÑÊÈÌ ÔÎÐÌÀÌ)_________________________________________ ________________________________________________________________________ ________ ________________________________________________________________________ ________ 3.(ÍÀÑÅËÅÍÍÛÅ ÏÓÍÊÒÛ, ÎÁÚÅÊÒÛ, ÑÐÅÄÈ ÊÎÒÎÐÛÕ ÂÛßÂËÅÍÛ Î×ÀÃÈ ÈÍÔÅÊÖÈÎÍÍÛÕ ÇÀÁÎËÅÂÀÍÈÉ)__ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________ 4. (Ð-ÍÛ)__________________________________________________________________ ______ ________________________________________________________________________ ________ âûÿâëåíû ýïèçîîòèè_(ÓÊÀÇÀÒÜ ÍÎÇÎËÎÃÈ×ÅÑÊÈÅ ÔÎÐÌÛ)_________________________________ ________________________________________________________________________ ________ ñðåäè(ÑÅËÜÑÊÎÕÎÇßÉÑÒÂÅÍÍÛÕ, ÄÎÌÀØÍÈÕ ÆÈÂÎÒÍÛÕ, ÄÈÊÈÕ ÃÐÛÇÓÍÎÂ)______________________ ________________________________________________________________________ ________ 5.Ñàíèòàðíî-ãèãèåíè÷åñêîå ñîñòîÿíèå(ÒÅÐÐÈÒÎÐÈ, ÍÀÑÅËÅÍÍÛÕ ÏÓÍÊÒÎÂ)__________________ ________________________________________________________________________ ________ (ÓÄÎÂËÅÒÂÎÐÈÒÅËÜÍÎÅ ÈËÈ ÍÅÓÄÎÂËÅÒÂÎÐÈÒÅËÜÍÎÅ) ïî ïðèçíàêàì__________________________ ________________________________________________________________________ ________ 6.Îáñëåäîâàíû âîäîèñòî÷íèêè(ÍÀÑÅËÅÍÍÛÅ ÏÓÍÊÒÛ, ÕÀÐÀÊÒÅÐ ÂÎÄÎÑÍÀÁÆÅÍÈß, ÄÅÁÈÒ ÇÀÊÐÛÒÛÕ ÂÎÄÎÈÑÒÎ×ÍÈÊÎÂ, ÄÀÒÜ ÇÀÊËÞ×ÅÍÈÅÎ ÏÐÈÃÎÄÍÎÑÒÈ ÂÎÄÛ)__________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________ 7. (ÍÀÑÅËÅÍÍÛÅ ÏÓÍÊÒÛ)___________________________________________________________ èìåþòñÿ (ÁÀÍÈ, ÑÀÍ. ÏÐÎÏÓÑÊÍÈÊÈ,Ñ ÏÐÎÏÓÑÊÍÎÉ ÑÏÎÑÎÁÍÎÑÒÜÞ)___________________________ ________________________________________________________________________ ________________________________________________________________________ ________________ (ÑÝÓ, ËÅ×ÅÁÍÛÅ Ó×ÐÅÆÄÅÍÈß, ÈÕ ÊÎÅ×ÍÀß ÅÌÊÎÑÒÜ,  Ò.× ÈÍÔÅÊÖÈÎÍÍÛÅ ÊÎÉÊÈ)_________________ ________________________________________________________________________ ________ ________________________________________________________________________ ________ ________________________________________________________________________ ________ 8. (ÍÀÑÅËÅÍÍÛÅ ÏÓÍÊÒÛ) __________________________________________________________ ____________________________________________________èìåþòñÿ çàïàñû ìåäèöèíñêîãî èìóùåñòâà (ÍÀÈÌÅÍÎÂÀÍÈÅ, ÊÎËÈ×ÅÑÒÂÎ)______________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________ 9.Â(ÐÀÉÎÍÛ ÐÀÑÏ-ß, ÍÀÑÅËÅÍÍÛÅ ÏÓÍÊÒÛ) ______________________________________________ ________________________________________________________________________ ________ îòîáðàíû ïðîáû äëÿ ñïåöèôè÷åñêîé èíäèêàöèè áàê. ñðåäñòâ(ÏÐÈ ÍÀËÈ×ÈÈ ÔÀÊÒΠÏÐÈÌÅÍÅ ÍÈß ÏÐÎÒÈÂÍÈÊÎÌ ÁÀÊ. ÎÐÓÆÈß, ÐÅÇÓËÜÒÀÒΠÈÍÄÈÊÀÖÈÈ ÏÐÈÁÎÐÀ ÀÑÏ) ________________________ (ÓÊÀÇÀÒÜ ÊÎËÈ×ÅÑÒÂÎ ÏÐÎÁ È ÊÓÄÀ ÍÀÏÐÀÂËÅÍÛ)___________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________ 10. îòíîøåíèè âûÿâëåííûõ ýïèä. î÷àãîâ (ÊÎÍÊÐÅÒÍÛÅ ÍÎÇÎËÎÃÈ×ÅÑÊÈÅ ÔÎÐÌÛ)___________ ________________________________________________________________________ ________________________________________________________________________ ___________________________________ïðîâåäåíî(ÓÊÀÇÀÒÜ ÏÅÐÅ×ÅÍÜ ÏÐÎÂÅÄÅÍÍÛÕ ÌÅÐÎÏÐÈßÒÈÉ)______________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________ ________________________________________________________________________ ________ (äîëæíîñòü) ________________________________________________________________________ ________ (Â/çâàíèå,ïîäïèñü,äàòà)