Derivar a un Paciente Información del paciente Nombre Apellido Fecha de nacimiento del paciente País del paciente Please SelectAland IslandsAlbaniaAlgeriaAmerican SamoaAfghanistanAndorraAngolaAnguillaAntarcticaAntigua & BarbudaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote dIvoireCroatiaCubaCuraçaoCyprusCzechiaCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands MalvinasFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGBGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIranIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Republic ofKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSt. HelenaSt. LuciaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnknownUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishWallis and FutunaWestern SaharaYemenZambiaZimbabwe Información de médico derivador Nombre de médico Apellido de médico Correo electrónico/email Teléfono ¿Cuál es el mejor horario para llamarlo por teléfono? - None -En la mañanaEn la tardeEn la noche ¿Como usted se enteró de nosotros? – Seleccionar –EmbajadaFamilia o amigoSeguroInternetNoticias/Medios/TVOtroReferencia médicoConferencia/Evento Otros detalles Información de la cita Motivo de la cita – Seleccionar –Visita de nuevo pacienteOtroSegunda opinión Un Diagnóstico – Seleccionar –Alagille SyndromeAllergic DisorderAlopeciaAnemiaApneaArrhythmiaArterio-venous MalformationArthritisAsthmaAtrial Septal DefectAttention Deficit Hyperactivity DisorderAutismAutoimmune DisorderBiliary DiseaseBone CancerBone Marrow TransplantBrain DamageBrain HemorrhageBrain TumorBurnCardiomegalyCardiomyopathyCardiovascular AbnormalityCeliac DiseaseCerebral InfarctCerebral PalsyCholesteatomaChronic Lung DiseaseChylothoraxCleft LipCleft PalateClub FootCongenital Cardiac AnomalyCongenital Cystic Adenomatoid MalformationCongenital SyndromeConstipationCraniofacial AbnormalityCraniosynostosisCryptorchidismCystic FibrosisDeep Venous Thrombosis (DVT)DermatitisDermatologic DisorderDevelopmental DelayDiabetesEating DisorderEdemaEncephalitisEncephalopathyEndocrine DisorderEosinophilic EsophagitisEpilepsyFacial DeformityFailure to ThriveFetal AnomalyFever of Unknown OriginFractureGastroenteritisGastroesophageal RefluxGastrointestinal DisorderGastroschesisGenetic DisorderGuillain Barre SyndromeHearing LossHeart FailureHemangiomaHematologic DisorderHemophiliaHepatitisHepato-splenomegalyHydrocephalusHydronephrosisHyperbilirubinemiaHyperinsulinismHypertensionImmunodeficiencyInfectious diseaseInflammatory Bowel DiseaseIntraventricular HemorrhageKidney DiseaseLeukemiaLiver FailureLymphadenopathyLymphomaMedicationsMeningo-MyeloceleMetabolic DisorderMusculoskeletal DisorderNerve DamageNeuroblastomaNeurofibromatosisNeurologic DisorderNeuromuscular DisorderObesityOncologic DisorderOphthalmic AbnormalityOrthopedic AbnormalityOsteogenesis ImperfectaOsteomyeolitisOtherOtolaryngology DisorderPancreatitisPlastic Surgical AnomalyPneumoniaPrecocious PubertyPrematurityPulmonary AbnormalityPulmonary HypertensionRenal DisorderRespiratory DisorderRetinitis PigmentosaRetinoblastomaRheumatologic DisorderScoliosisSeizure DisorderShort StatureSickle Cell AnemiaSpeech DisorderSpina BifidaSplenomegalyTethered CordTetralogy of FallotThalassemiaThrombocytopeniaTracheo-Esophageal FistulaTraumaTrisomy 13Trisomy 21TumorUrogenital AbnormalityVascular MalformationViral SyndromeWell Child Care Información adicional Deje este campo en blanco