Anterior aspect, right tibia and fibula
| Cambury General Hospital | ||
| Name | Ward/ Dept. | Hosp. Reg. No. |
| I................................................................................................................. of……………………………………………………………………… . hereby consent to undergo the operation of.................................... the effect and nature of which has been explained to me. I also consent to such further or alternative operative measures as may be found to be necessary during the course of such operation, and to the administration of a local or other anaesthetic for the рифове of the same. I understand that an assurance has not been given that the operation will be performed by a particular surgeon. Dated this....................... …………day of........... ..…………………… (Signed)................................................................ ……………………. Operation Consent (Patient) |
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