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Avdeling

Siste dose:. Dato. Tid. Årsak til prøven blir tatt:. Nye MRI-lesjoner. Rutinkontroll. Forverring. Annen årsak:. Navn. Avdeling. Analyse av antistoff mot interferon beta. Sendes til: Likvorlab, Neurologiska kliniken R52, Att: Anna Ljungberg ,

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Avdeling

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  1. Siste dose: Dato Tid Årsak til prøven blir tatt: Nye MRI-lesjoner Rutinkontroll Forverring Annen årsak: Navn Avdeling Analyse av antistoff mot interferon beta Sendes til: Likvorlab, Neurologiska kliniken R52, Att: Anna Ljungberg, Huddinge Universitetssjukhus, 141 86 Stockholm Lege: Dato: Tid: Diagnose: Aktuell behandling: Avonex Betaferon Rebif 22 g Rebif 44 g Behandlet med interferon beta (oppgi i måneder) Behandling avsluttet siden (oppgi i måneder) Instruksjoner for hvordan prøven skal tas, se baksiden!

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