Page 1

Foot Function and 3-Box Gait Report ErgoTEC Tecnologico de Costa Rica

Patient Claudia Sanchez Name

Page 1 of 4 Claudia Sanchez Date Printed: 6/4/2018

Patient ID

123

DOB

15/12/2001

Date of Exam

6/4/2018

Time of Exam 4:39p. m. Examiner Alberto Sanchez Alvarado

Date of Exam

6/4/2018

Time of Exam 4:48p. m. Examiner

Gender F

Comparison of Exam Results: Left Foot Exam 6/4/2018, 4:39p. m.

Right Foot Con plantilla

Exam 6/4/2018, 4:39p. m.

Con plantilla


Foot Function and 3-Box Gait Report ErgoTEC Tecnologico de Costa Rica

Page 2 of 4 Claudia Sanchez Date Printed: 6/4/2018

Comparison of Exam Results: Exam 6/4/2018, 4:39p. m.

Exam 6/4/2018, 4:48p. m.


Foot Function and 3-Box Gait Report ErgoTEC Tecnologico de Costa Rica

Comparison of Exam Results:

Page 3 of 4 Claudia Sanchez Date Printed: 6/4/2018


Foot Function and 3-Box Gait Report ErgoTEC Tecnologico de Costa Rica

Patient Name: Patient ID: DOB: Gender:

Page 4 of 4 Claudia Sanchez Date Printed: 6/4/2018

Claudia Sanchez 123 15/12/2001 F

Comments and Observations

Signed:

_______________________________________________________________

Dated:

_______________________________________________________________

Análisis de marcha  
Análisis de marcha  
Advertisement