<?xml version="1.0" encoding="utf-8" standalone="no"?>
<TfrxReport Version="4.14" DotMatrixReport="False" EngineOptions.TempDir="C:\Users\ADMINI~1\AppData\Local\Temp\" IniFile="\Software\Fast Reports" PreviewOptions.Buttons="4095" PreviewOptions.Zoom="1" PrintOptions.Printer="OneNote 2013'e Gönder" PrintOptions.PrintOnSheet="0" ReportOptions.CreateDate="42116,4005644213" ReportOptions.Description.Text="" ReportOptions.LastChange="42116,4206798148" ScriptLanguage="PascalScript" ScriptText.Text="begin&#13;&#10;&#13;&#10;end." PropData="044C65667403E00103546F7002080844617461736574730101062620446174615365743D22667278646174612220446174615365744E616D653D226461746131220000095661726961626C65730100055374796C650100">
  <TfrxDataPage Name="Data" Height="1000" Left="0" Top="0" Width="1000"/>
  <TfrxReportPage Name="Page1" PaperWidth="210" PaperHeight="297" PaperSize="9" LeftMargin="10" RightMargin="10" TopMargin="10" BottomMargin="10" ColumnWidth="0" ColumnPositions.Text="" HGuides.Text="" VGuides.Text="">
    <TfrxMemoView Name="Memo1" Left="75,5906" Top="18,89765" Width="570,70903" Height="26,45671" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="1" HAlign="haCenter" ParentFont="False" Text="RAHİM AGZI (SERVİKS) KANSER TARAMASI BİLGILENDİRİLMİŞ ONAM FORMU "/>
    <TfrxRichView Name="Rich1" Left="15,11812" Top="45,91342" Width="684,09493" Height="619,84292" ShowHint="False" GapX="2" GapY="1" PropData="[encoded data, 14024 characters]"/>
    <TfrxMemoView Name="Memo2" Left="15,11812" Top="700,99258" Width="283,46475" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Hasta ya da Hukuksal Olarak Sorumlu Kişi:"/>
    <TfrxMemoView Name="Memo3" Left="15,11812" Top="723,66976" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Adı Soyadı"/>
    <TfrxMemoView Name="Memo4" Left="15,11812" Top="746,34694" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="TC Numarası"/>
    <TfrxMemoView Name="Memo5" Left="15,11812" Top="769,02412" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Tarih"/>
    <TfrxMemoView Name="Memo6" Left="15,11812" Top="791,7013" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="İmza"/>
    <TfrxMemoView Name="Memo7" Left="15,11812" Top="837,05566" Width="283,46475" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Tanık"/>
    <TfrxMemoView Name="Memo8" Left="15,11812" Top="859,73284" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Adı Soyadı"/>
    <TfrxMemoView Name="Memo9" Left="15,11812" Top="882,41002" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Hukuksal Yakınlığı"/>
    <TfrxMemoView Name="Memo11" Left="15,11812" Top="905,0872" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="İmza"/>
    <TfrxMemoView Name="Memo10" Left="377,953" Top="700,99258" Width="283,46475" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Hasta ya da Hukuksal Olarak Sorumlu Kişi:"/>
    <TfrxMemoView Name="Memo12" Left="377,953" Top="723,66976" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Adı Soyadı"/>
    <TfrxMemoView Name="Memo13" Left="377,953" Top="746,34694" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="TC Numarası"/>
    <TfrxMemoView Name="Memo14" Left="377,953" Top="769,02412" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Tarih"/>
    <TfrxMemoView Name="Memo15" Left="377,953" Top="791,7013" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="İmza"/>
    <TfrxMemoView Name="Memo16" Left="377,953" Top="837,05566" Width="283,46475" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Tanık"/>
    <TfrxMemoView Name="Memo17" Left="377,953" Top="859,73284" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Adı Soyadı"/>
    <TfrxMemoView Name="Memo18" Left="377,953" Top="882,41002" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Hukuksal Yakınlığı"/>
    <TfrxMemoView Name="Memo19" Left="377,953" Top="905,0872" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="İmza"/>
    <TfrxMemoView Name="Memo20" Left="377,953" Top="676,53587" Width="283,46475" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="1" ParentFont="False" Text="TETKİKİN REDDİ:"/>
    <TfrxMemoView Name="Memo21" Left="15,11812" Top="935,32344" Width="362,83488" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="1" ParentFont="False" Text="Bilgilendirme Yapan Sağlık Personeli:"/>
    <TfrxMemoView Name="Memo22" Left="15,11812" Top="963,78015" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Adı Soyadı"/>
    <TfrxMemoView Name="Memo23" Left="15,11812" Top="986,45733" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="TC Numarası"/>
    <TfrxMemoView Name="Memo24" Left="15,11812" Top="1008,69357" Width="136,06308" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="Tarih"/>
    <TfrxMemoView Name="Memo25" Left="151,1812" Top="723,66976" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo26" Left="151,1812" Top="746,34694" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo27" Left="151,1812" Top="769,02412" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo28" Left="151,1812" Top="791,92177" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo29" Left="514,01608" Top="723,66976" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo30" Left="514,01608" Top="746,34694" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo31" Left="514,01608" Top="769,24459" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo32" Left="514,01608" Top="791,92177" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo33" Left="513,79561" Top="859,73284" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo34" Left="513,79561" Top="882,41002" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo35" Left="513,79561" Top="905,30767" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo36" Left="151,1812" Top="859,95331" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo37" Left="151,1812" Top="882,63049" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo38" Left="151,1812" Top="905,52814" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo39" Left="151,1812" Top="963,78015" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo40" Left="151,1812" Top="986,45733" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="Memo41" Left="151,1812" Top="1009,35498" Width="7,55906" Height="18,89765" ShowHint="False" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text=":"/>
    <TfrxMemoView Name="data1TCKIMLIKNO" Left="158,74026" Top="723,66976" Width="204,09462" Height="18,89765" ShowHint="False" DataSet="frxdata" DataSetName="data1" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="[data1.&#34;ADI&#34;] [data1.&#34;SOYADI&#34;]"/>
    <TfrxMemoView Name="Memo42" Left="158,74026" Top="746,34694" Width="204,09462" Height="18,89765" ShowHint="False" DataField="TCKIMLIKNO" DataSet="frxdata" DataSetName="data1" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="[data1.&#34;TCKIMLIKNO&#34;]"/>
    <TfrxMemoView Name="Memo43" Left="158,74026" Top="769,02412" Width="204,09462" Height="18,89765" ShowHint="False" DataSet="frxdata" DataSetName="data1" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="[Date]"/>
    <TfrxMemoView Name="kullaniciadisoyadi" Left="158,74026" Top="963,78015" Width="204,09462" Height="18,89765" ShowHint="False" DataSet="frxdata" DataSetName="data1" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="DR. AYNUR USLU"/>
    <TfrxMemoView Name="kullanicitckimlikno" Left="158,74026" Top="986,45733" Width="204,09462" Height="18,89765" ShowHint="False" DataSet="frxdata" DataSetName="data1" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="16160446626"/>
    <TfrxMemoView Name="Memo46" Left="158,74026" Top="1009,13451" Width="204,09462" Height="18,89765" ShowHint="False" DataSet="frxdata" DataSetName="data1" Font.Charset="1" Font.Color="-16777208" Font.Height="-13" Font.Name="Arial" Font.Style="0" ParentFont="False" Text="[Date]"/>
  </TfrxReportPage>
</TfrxReport>
