Professional Documents
Culture Documents
COLLEGE OF NURSING
Malaybalay City
Date: __________________
Time Started: ___________
Time Ended: ____________
Hospital/Agency: _______________________________________________________________
Name of Patient: _____________________________________________ Age: __________
Case Number: _______________________________________________ Sex: __________
Address: ______________________________________________________________________
Operation Performed:
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Diagnosis: ____________________________________________________________________
Pre- Operative:
_____________________________________________________________________________
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Post- Operative:
_____________________________________________________________________________
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Anesthesia Used:
_____________________________________________________________________________
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Name of Staff/ Signature: ________________________________________________________