31. 1. 201716. 10. 2019 Miroslav Cihlo Follow-Up SENSOR RESERVOIR® Registry Hospital name and Department nameHospital AddressDate of measurementDuration of SENSOR RESERVOIR implantation (days/months)SENSOR RESERVOIR ID numberFollow-Up Pressure MeasurementsLying/recumbent position: Single measurement:Time of dayPressurePressurecm WSm barmm HgTorrhPaplease select the appropriate unitpulsatility visible?YesNoRemarkStanding/sitting/upright position:If possible/optionalTime of dayPressurePressurecm WSm barmm HgTorrhPaplease select the appropriate unitRemarkIf the SENSOR RESERVOIR was revised (surgically removed), please fill in the “REVISION” form.DateNameSignature E-mail This iframe contains the logic required to handle Ajax powered Gravity Forms.