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Bone and Soft Tissue Tumor

Home
/Conditions
/Bone and Soft Tissue Tumor
/Application Form

Bone and Soft Tissue Tumor

Please fill in the form completely.

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Patient Information

Full Name *

Age *

Gender *

Type of Tumor You Want to Consult

Tumor Type You Want to Consult About

Bone Tumor

Soft Tissue Tumor

Metastasis

What is your complaint?

What are your complaints?

Fracture

Pain

Swelling

Other

Disease Information

How long does your symptom last?

1-3 Months

3-6 Months

6-12 Months

+1 Year

What is the history of your complaint?

Do you have any other diseases?

Do you smoke?

Yes

No

How often do you smoke?

Do you have a history of previous surgery?

Yes

No

What surgeries have you had?

Is there any cancer disease in your family?

Yes

No

If any, what type of cancer?

Is there any previous cancer treatment?

Yes

No

If any, what type of cancer?

Radiation therapy

Yes

No

Drug therapy (Chemotherapy)

Yes

No

Inspections

No diagnostic procedures

Biopsy report

Postoperative organ pathology report

Direct radiography report

Computed tomography

Whole Body Bone Scintigraphy

Angiography

KYD MRI

Hemogram (Complete Blood Count) Report

Biochemistry Report

External photo of bone or soft tissue tumor

I have read and understood the Information and Consent Text regarding the Provision of Remote Healthcare Services and hereby accept its terms.*

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