KARDEX

Name: Address: Service/Attending Physician: CC/Diagnosis: AGE SEX Wt. Classification: Date & Time of Admission: Hospital Case No. Blood Type: Bed No.:

Operation: Date Ordered Diet Vital Signs IV IVFTF Date D/C

Date of Operation: Date of Delivery: Medical Treatment/Laboratory/Procedures

Medicines

Side Drip/BT Contraptions Special Needs

KARDEX
Name: Address: Service/Attending Physician: CC/Diagnosis: AGE SEX Wt. Classification: Date & Time of Admission: Hospital Case No. Blood Type: Bed No.:

Operation: Date Ordered Diet Vital Signs IV IVFTF Date D/C

Date of Operation: Date of Delivery: Medical Treatment/Laboratory/Procedures

Medicines

Side Drip/BT Contraptions Special Needs