You are on page 1of 1

ASTRODIAGNOSIS

Nombres: ............................................................................................. Apellido: ........................................................................


Fecha de nacimiento:....................Hora de nacimiento: ...................... Localidad de nacimiento: ..............................................
Hora de consulta:.................................................................................. [ Hora de nacimiento rectificada: ................................]

Observaciones: ..........................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
.....................................................................................................................................................................................................
w w w . a s t r o l o g i a a n a l i t i c a . c o m . a r - a s t r o a n a l i t i c @ y a h o o . c o m. a r

You might also like