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PATIENT NAME
PATIENT NUMBER
DOB
AGE(YRS)
MONTHS
DAYS
Gender
0
0
0
Doctor instructions
Instructions
Sent By
Date
Time
Executed
Action
Demographic Data
Nursing Cardex Form
Allocate Bed
Nursing Care Plan
Nursing Notes
Blood Pressure Chart
Fluid Balance Chart
Blood transfusion observation chart
Theatre Pre-operative Check List
Theatre Operation Notes
Anaesthetic Record
Theatre Consumption List
Injections/Fluids
Food
Doctor Instructions
xx
Nursing Cardex
×
History of the Current Disease
Past Medical/Surgical History
Food and Drug Allergies
Family medical History
Social & Economic
History
Past & present Obstetric History
Developmental History
Physical Examination
Allocate bed
Bed
Status
Action
Demographic Data
×
BWT
TEMP
HT
BH / MUAC
BP
PULSE
Nursing Care Plan
×
Assessment
Nursing Diagnosis
Goal/Expected Outcome
Intervention / Plan Of Action
Rationale
Implementation
Evaluation
Nursing Notes
×
Notes
Blood Pressure Chart
×
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