## Pravilnik o obrascima zdravstvene dokumentacije djece predškolske dobi i evidencije u dječjem vrtiću

### NN 114/2002 (1.10.2002.), Pravilnik o obrascima zdravstvene dokumentacije djece predškolske dobi i evidencije u dječjem vrtiću

# MINISTARSTVO ZDRAVSTVA

1846

Na
temelju članka 52. stavka 3. Zakona o predškolskom odgoju i naobrazbi (»Narodne
novine«, br. 10/97.) ministar zdrav­stva donosi

## PRAVILNIK

### O OBRASCIMA ZDRAVSTVENE DOKUMENTACIJE DJECE PREDŠKOLSKE DOBI I EVIDENCIJE U DJEČJEM VRTIĆU

Članak
1.

Ovim
Pravilnikom propisuju se obrasci:

–
potvrde o obavljenom sistematskom zdravstvenom pregledu predškolskog djeteta
prije upisa u dječji vrtić

–
potvrde o obavljenom zdravstvenom pregledu pred­škol­skog djeteta (izostanak
zbog bolesti ili nekog drugog razloga)

–
zdravstvenog kartona djeteta u dječjem vrtiću

–
evidencije o zdravstvenom odgoju

–
evidencije o higijensko-epidemiološkom nadzoru

–
evidencije o sanitarnom nadzoru

– evidencije epidemioloških indikacija

– evidencije ozljeda te

– evidencije antropometrijskih mjerenja.

Članak 2.

Obrazac potvrde o obavljenom sistematskom
zdravstvenom pregledu predškolskog djeteta prije upisa u dječji vrtić tiskan je
u Prilogu 1. koji je sastavni dio ovoga Pravilnika.

Članak 3.

Obrazac potvrde o obavljenom zdravstvenom pregledu
pred­školskog djetetazbog izostanka zbog bolesti ili nekog drugog
razloga tiskan je u Prilogu 2. koji je sastavni dio ovoga Pravilnika.

Članak 4.

Obrazac zdravstvenog kartona tiskan je u Prilogu 3. koji
je sastavni dio ovoga Pravilnika.U zdravstveni karton ulaže se potvrda
o obavljenom sistematskom zdravstvenom pregledu predškolskog djeteta prije
upisa u dječji vrtić i potvrde o obavljenom zdravstvenom pregledu predškolskog
djetetazbog izostanka zbog bolesti ili nekog drugog razloga*.*

Članak 5.

Obrazac Evidencije o zdravstvenom odgoju tiskan je u
Prilogu 4. koji je sastavni dio ovoga Pravilnika.

Članak 6.

Obrazac Evidencije o higijensko-epidemiološkom
nadzoru tiskan je u Prilogu 5. koji je sastavni dio ovoga Pravilnika.

Članak 7.

Obrazac Evidencije o sanitarnom nadzoru tiskan je u
Prilogu 6. koji je sastavni dio ovoga Pravilnika.

Članak 8.

Obrazac Evidencije epidemioloških indikacija tiskan
je u Prilogu 7. koji je sastavni dio ovoga Pravilnika.

Članak 9.

Obrazac Evidencije ozljeda tiskan je u Prilogu 8.
koji je sastavni dio ovoga Pravilnika.

 Članak 10.

Obrazac Evidencije antropometrijskih mjerenja tiskan
je u Prilogu 9. koji je sastavni dio ovoga Pravilnika.

Članak 11.

Ovaj Pravilnik stupa na snagu osmog dana od dana
objave u »Narodnim novinama«.

Klasa: 011-01/02-01/0182
Urbroj: 534-02-26-02-0002
Zagreb, 30. kolovoza 2002.

            Ministar

            **mr.
sc.** **Andro Vlahušić,
dr. med.,** v. r.

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 Prilog 1.

Liječnik:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dom
zdravlja/ambulanta: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Adresa: :\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Telefon: :\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Radno vrijeme:  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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**POTVRDA O OBAVLJENOM SISTEMATSKOM ZDRAVSTVENOM PREGLEDU
PREDŠKOLSKOG DJETETA PRIJE UPISA U DJEČJI VRTIĆ**

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Ime i
prezime\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dan, mjesec, godina rođenja \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

JMBG\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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Obavljen sistematski pregled
liječnika
DA                                           NE

Obavljen
sistematski pregled stomatologa                        DA
                                          NE

Dijete je
redovito cijepljeno                                             DA
                                          NE

Razlozi zbog
kojih nije provedeno cijepljenje

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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Mjere
posebne skrbi u dječjem vrtiću:             POTREBNE
SU             NISU
POTREBNE

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Napomene:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DIJETE JE SPOSOBNO ZA POHAĐANJE DJEČJEG VRTIĆA:
      DA                 NE

Datum \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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                                                                                                                                    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

                              Faksimil i
potpis liječnika

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 Prilog 2.

Liječnik:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dom
zdravlja/ambulanta: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Adresa: :\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Telefon: :\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Radno vrijeme:  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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POTVRDA O OBAVLJENOM ZDRAVSTVENOM PREGLEDU
PREDŠKOLSKOG DJETETA

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Izostanak
zbog bolesti                                                             Izostanak
zbog drugog razloga (zaokruži-podcrtaj)

Ime i prezime \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dan, mjesec, godina rođenja \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Izostao/la
               od
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ do \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Dijagnoza
bolesti (MKB)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Mjere
posebne skrbi u dječjem vrtiću:               POTREBNE
SU                 NISU
POTREBNE

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Napomene:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DIJETE JE SPOSOBNO ZA POHAĐANJE
DJEČJEG VRTIĆA:
      DA                 NE

Datum
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                                  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

                                                                                                              Faksimil i
potpis liječnika

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Prilog 3

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_               \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

                  Dječji vrtić                                                    skupina

ZDRAVSTVENI KARTON DJETETA U DJEČJEM VRTIĆU

Ime i
prezime:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_           spol:   M / Ž

Datum rođenja: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Adresa stanovanja i telefon: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

JMBG \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Ime majke: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_     Ime
oca: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Zanimanje: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_     Zanimanje: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Zaposlena: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      Zaposlen: –––––––––––––––––––––––––––––––––––––––––––

                                    (naziv,
adresa)                                                                    (naziv,
adresa)

              \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_         \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

                                         (telefon)                                                                             (telefon)

Podaci o izabranim liječnicima primarne zdravstvene zaštite

pedijatar/liječnik opće medicine: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

adresa i telefon ambulante: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

dom zdravlja: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

radno vrijeme: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

stomatolog: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

adresa i telefon ambulante: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

dom zdravlja: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

radno vrijeme: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

NAPOMENE:

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PODACI O CIJEPLJENJU (ZDRAVSTVENI KARTON STR. 2)

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| if !supportEmptyParas endif | I. | | II. | | III. | | IV. | | V. | |
| BCG | DA | NE | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif |
| Di-Te-Per | DA | NE | DA | NE | DA | NE | DA | NE | DA | NE |
| Polio | DA | NE | DA | NE | DA | NE | DA | NE | DA | NE |
| Mo-Pa-Ru | DA | NE | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif | if !supportEmptyParas endif |
| Hib | DA | NE | DA | NE | DA | NE | DA | NE | if !supportEmptyParas endif | if !supportEmptyParas endif |

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Pravilnik, NN 114/2002-1846
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