Varicose Vein Surgery Post-Operative Follow-up Form
Patient Information
Name
Date of Birth
Contact
Surgery Details
Date of Surgery
Type of Surgery
Operated Leg
Left
Right
Both
Symptoms
Pain
Swelling
Redness
Numbness
Wound Discharge
Signs of Infection
Wound Assessment
Wound Healing
Normal
Delayed
Infected
Remarks
Doppler/Imaging Result
Result
Medications
List
Next Follow-up
Date
Notes
Additional Notes