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S.C AUDIONET SSI BRAILA Adrlrc::.5tEFAN l-rl Mat<l llb Etut20 BRATLA Web: (-ert.('alihrare Nr.355113 07 2()llsrrrr,r, r ROMANIA E-rlail : ivan99doru@1'ah(x).conr Phone: 0724554508 Fax 0239-624066 No Subject Data Printout Itl N,r.: 591 Addlcss. Exanr i ner: Instrurne nt Right I I I I lrr .- -Lr -H | !:=:.;,i ti r.r,:l :rr I. 'rii-l - l-F - I I.:i! n 0.{1 nrl - 1!l ,laP"r 0. [r . lij rl -iliri Reflex :tnJ Left 1 "t, I -4. . r1 I il li l I I 1 1 ,l /r. -l- I -,, 1 | __'.---'1 iiil I L.,- l- i;l:1 1; ; l .r i irl !. 1: rr::11, jt-t:rij !.1a n- n5 qr, Fl.- o n1 l. 1: ::l :l : r.t: ] t,. [.].1 I I-,rllz I $1 - -_ _- t,,li t,. :.:: lUil[tHz ]l // I .?-- lOI dBHL nl tr, r5 -- -- -- 0,1[ 0,05 5rlltllz n ,i,-..-1_:t:: lr: I L,rL riil-l: :.151 1 t.05 0 a ^ CL .LEI L li',..;r,i ,. i' l,:f': I l) r ^hF f\!Yrru Tl-,r-rr ,r . j t=f A Ir lli :l I Fl. rt uL {t .15 t ti '- -'Ir.rl . ',,',,1 r' ' l-li i^- + !t-j lf t- ,-lgHL dl - :.1: .i,1 1r r'11_1' 1 , __ ! -tl.l J n.1r l- F1: n t.15 a -' -' _ t,l: p5l l.:: JIJL]LJHZ : l r,l !. t:1 r,-l L-l r -l ] t, . ,,,.,,. 1 i-.rt-t. ] 1 ]E FI! frl o. 1! Se.rue nc'; ,-. ,o llon I r.r o, ,, 5 -rt llr n dBut l{-rL-r - ,rl t I'r1,1'1'',-l ,*1. 1 , "',,;'.)*r' t
S.C AUDIONET SSI BRAILAAdrlrc::.5tEFAN l-rl Mat<l llb Etut20 BRATLA
Web: (-ert.('alihrare Nr.355113 07 2()llsrrrr,r, r
ROMANIA E-rlail : ivan99doru@1'ah(x).conr
Phone: 0724554508 Fax 0239-624066 No
Subject Data PrintoutItl N,r.: 591
Addlcss.
Exanr i ner:
Instrurne nt
Right
I
III lrr .- -Lr
-H | !:=:.;,iti r.r,:l :rr I.
'rii-l - l-F -
I
I.:i! n0.{1 nrl
- 1!l ,laP"r 0.[r . lij rl
-iliri
Reflex
:tnJ
Left
1
"t,
I
-4. .
r1 I il li
lI
I
1
1
,l/r.-l- I -,,
1
| __'.---'1
iiil
IL.,-l- i;l:1 1;; l .r i
irl!. 1:
rr::11, jt-t:rij !.1an- n5
qr, Fl.- o
n1
l. 1:::l :l : r.t:
] t,. [.].1I I-,rllz I
$1
- -_ _- t,,lit,. :.::lUil[tHz ]l
//I .?--
lOI dBHL
nltr, r5
-- -- -- 0,1[0,05
5rlltllz n
,i,-..-1_:t::lr:
I L,rL riil-l:
:.1511
t.050
a ^ CL.LEI L
li',..;r,i ,. i' l,:f':
I
l) r ^hFf\!Yrru
Tl-,r-rr ,r . j t=f A
Ir lli
:l I Fl.
rt uL
{t.15 tti'- -'Ir.rl
.
',,',,1 r' '
l-lii^-+ !t-j lf t- ,-lgHL
dl- :.1:.i,1 1r r'11_1' 1 , __
! -tl.l J n.1rl- F1: n
t.15a-' -' _ t,l:
p5l l.::JIJL]LJHZ :
l
r,l!. t:1
r,-l L-l r -l
] t, . ,,,.,,. 1
i-.rt-t. ]
1 ]E FI!
frlo. 1!
Se.rue nc'; ,-. ,ollon I r.r o, ,,5 -rt llr n
dBut l{-rL-r
- ,rl t I'r1,1'1'',-l,*1.
1 , "',,;'.)*r't
ReflexRight
Pressure -19 daPa
T -
!!LC-L L
rlrrltLtti: -t/ tdl d
l:+qr:er,:er-'Lrt I d
I l-l- -lr.
't-,_ -. --
C'-,rl rr. -:
nl4r,151
0, 10
I,il5: L
I
F
1
Tone Audiogram
nlo. 15c^^. ^-^-
)t-\l1t.t d ar5
I t-rtlUH.= !
dl
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rr(tltlrt -.^-
:ir - ,l-l: :
A1
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bU 'tt'nL
.- nl0, l:1l. Lrl, =f
;+ Irlll dBHL I Lltr lEtrll
flt[-15+
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.11, I -rHz ]
1 r00\"/
dBHL
Right Left
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MINICAMTI\JT T
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IS T, ,AUDIONET SSI BRAILA Weh: Cert.Cal ihrare:-529/[)2.07. ] i Sr r n,, r,
Addless: STEFAN CEL MARE 226 810126 BRAILAROMANIA E-mail : ivan99doru@yah()o.conr
i)hone: 0724-t54508 Fax 0239-624066 No.:
Subject Data Printout
Phone2,t
Nartte
\ cl rl rcss
Il-rrrail
l{enu lks
Sex:
Age:
Examiner:
Instrument: AA222
Right Le ft
I
I t-' tjl- i:'l:l;: -
,r .:J ,:r l:
:i-t[]il;:Fi:
3nl
1
I.i, l r'L .ll r'rl a lt- ti i
_{lr.
Reflex
_+l
rltt:
at.
i,1t JIiil :l:F :
RightPrc.:=Lrr+ i'12 -lrF,r
LC'l. L
F r ,:::,1r r: l -', ':l;rF l
/)
l
i lflll
nlr,. 1-r
- ' - :.1:i r-,- :. :5
rl:.1:
- _.1:
ii::, :.!iIi"li-ltlHt ,:
-]BHL
:lEil-lt
JFI'rt
tlBl-ll
Sequenct
5iltlHz
S,]qLJence
lpsrlutl0Hz
ni0. l50, 10
0,05
!1::
l:-
IrrH: !
Il:.1:
!jlI
I : :.rr!ir..,l-l: :
, ,lr,rrri-'lii:
Ir.1rtI
ill:,15
-- _ :.1t:,5 I :, t:
lUijl-lHz r
F5 I
t itltrFl:
r'''1rrl.1t.I tr ;: ''1irr
'' - _ - I lrL
r,,-l tt J i ni5rLLlHz E
80
t), ;!'l
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i
k,:
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wq
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t.,:q l: '
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I , rirH:
rlil. 1:
11, Lt
:,tr:rl
fll!. 15
RightPre==ure 1{2 daPa
Reflex
LlonI r:1 .l0L-rll:
i--..-^^^
|]ont r':2t]00Hz
iii:qr.-r :rt,:ef,t,nt ra{r_LtluH:
ETF
':tnl
I
1.tLB ml
-{0 daPa n)rtLJ ild I
T -
CLLCI L
Fr':€itrTr: /'-l daFr
, lE lrLILJL]
lhl I lt ,,
,IBHL100
:.!,
tu1;: " Right Left:.f
Ll,
-t:,iiil
rll
.t,l
JL LIUdI d
far UolurnePressure 1
Frr.,:,-rff 2
Fres:ure 3
Tone
L-, ,', .t.
' l- I ri-r:ir-/tr:lf 1.- t.
300dePa Fre=='-r' ltJ L-13- a -bUU - JUU
Aucli ogram
i':
Right Left
l
Hearing EvaluationReport
Frequencv in Hertz (Hz) Frequency in Hertz (Hz)2-50 ?00 lK 2K 4K BK 12\ 250 50C 1K 2K 4K 8K
l
Glient Name: GROSU,MIRELA ELENAClient #: 0000551Birthdate: 1210411974Date of Evaluation | 3110A2013
l
lLeger tu
A o fi'-ogg .g,ni ' , t , , ' ;,;i . .'- .'. 1 Ac o
o:
-'Legend
I -""""1
u n",,", L
AcoxU nnas<ed
"": i_ pL.e I one Notes
Speech Nores ^r-L^/i^^^^r
Speech Nores fulake/[,4ooel
:::::::i,.-. ] ic1brel.nDa'iem_l
9lA A fl A
ErrectiveMasking Levets 8000 Ef/ruCtl(<eNonjlesl
Ear 125 25O 5OO 75A 1OOO ,1500 2OOO 3000 4O0O 6000
^.' I [ l I I i I I I - a/A /tg.al .2a/3R I I T----I-T- QlJ /"r'ffi- lffi
taba,o'Da,e ,es,,v1e,ao.i
ffiffi_slRel ao \
_Connenrs Comments
user Deirnea 1 userDetr-ed, --\* ..Ola
use'De'nedr-_ =_-;r";",,"".r-_p-
C - c UnTasked
tI)O.ocll
A;vasieorrj, :
Xbucl mrnTri!oII
Legend
8!l
. r0 wI
S,n . . G
1t-)
2i) I (r 'il i.l) "ti.) .9il :r: iil
Hearing Level in Decibels (dB)
Report Comments
Izra L i!
I
Signature: Date:
