DAILY FLOOR CENSUS

For the 24 Hours Ended Midnight

600
3/14/xx

ADMITTED
8:30
9:59
12:02
16:40
22:10

Parton, Dolly
Fonda, Jane
Hutton, Lauren
Fox, Michael
Cruise, Tom

TRANSFERRED IN
15:00

ROOM#
602-2
610-2
620-1
612-1
601-2

Tomlin, Lily

M.R.#
136093

ROOM #
616-1

Hall, Dennis

M.R. #
146052

Room #
618-1

DEATHS
20:10

M.R. #
400029
194360
410001
347777
236470

TIME

20xx

TRANSFERRED OUT
14:00 Houston, Mary

LINE #
1
2
3
4
5
6
7
8

M.R.#

ROOM#

M.R. #
176070

ROOM #
616-2

NAME

Remaining Last Report

Admitted
Transferred In
Total (sum of lines 1, 2, 3)
Transferred Out
Discharged
Died
Total (sum of lines 5, 6, 7)

Newborns
0
0
0
0
0
0
0
0

A&C
35
5
1
41
1
0
1
2

SIGNED_Christina Usher

A&D TOTAL=______

Remaining Midnight (Line 4-Line 8)

39