REDOBLE MEDICAL CLINIC

Temperature and Pulse Respiration record

Family name First name Middle Attending Physician Room no. Bed No.

Day of month
Day of hospital
Day of illness
R P Temp A.M P.M A.M P.M A.M P.M A.M P.M A.M P.M A.M P.M A.M P.M
P C

4
2

160

10
6

41

140

10 39
4
120

38

37

10
100 2
60 36

50 80 10
0

40 60

30 98

20

40
10

36

36
B Systolic 7- 3
3 -11
11- 7
P Diastolic 7- 3
3 -11
11- 7
Weight
Urine 7 -3
3 -11
11 -7
Stool 7 -3
3 -11
11- 7