Assessment of middle ear function in patients with cleft palate - 23
III. POST-SURGICAL FOLLOW-UP. Number of months: . 1. Administration 1.1a Medical record number:. 1.1b OS code:…. 1.2 Full name: .1.3 Gender: Male □ Female □ 1.4 Date of birth: .1.5 Age: . 1.6 Address: . 1.7 Date of surgery: / / 12. Potential energy: Yes│No│Unknown: 3.1 Hearing ...
