HTAR-SUR/ONCO/MNG-001

DEPARTMENT OF SURGERY ,HTAR KLANG MONTHLY RECORD OF CHEMOTHERAPY ADMINISTRATIONS IN ……………………YEAR 2011.
No
1 2 3 4 5 6 7 8 9 10 11 12 13 14

NAME OF PATIENTS

PT’S ID

DATE OF CHEMO ADM.

COURSE

CYCLE

REGIME

TREATMENT STRATEGY

DIAGNOSIS

TOTAL

Nnad 010109

HTAR-SUR/ONCO/MNG-002

DEPARTMENT OF SURGERY,HTAR KLANG WARD/UNIT:………..
STATISTIC O f TYPE OF CHEMOTHERAPY & RADIOTHERAPY -INPATIENT TO SRI KOTA HOSPITAL IN YEAR 2010

Month

Neoadjuvant chemotherapy

Adjuvant chemotherapy

Palliative chemo therapy

Concurrent ChemoRadio therapy

External Radio therapy

Palliative Radio therapy

Brachytherapy TOTAL

JAN FEB MAC APR MAY JUNE JULY AUG SEPT OCT NOV DEC TOTAL

Nnad 010109

HTAR-SUR/ONCO/MNG-003

DEPARTMENT OF SURGERY,HTAR KLANG WARD/UNIT:………..

RECORD OF RADIOTHERAPY PATIENTS TO SRI KOTA HOSPITAL IN YEAR 2009
NO Patient’s detail Diagnosis R/T appt. date Radical/ Ext.Beam Brachytherapy Palliative HTAR Total Fractions Remark

HTAR-SUR/ONCO/MNG-004

DEPARTMENT OF SURGERY,HTAR KLANG WARD/UNIT:………..
STATISTIC OF CHEMOTHERAPY EXTRAVASATION INCIDENCE IN YEAR 2010

Month

NUMERATOR

DENOMINATOR

PERCENTAGE (%)

REPORTED (YES/NO)

REMARKS

JAN FEB MAC APR MAY JUNE JULY AUG SEPT OCT NOV DEC

TOTAL
Nnad 010109

HTAR-SUR/ONCO/MNG-005

DEPARTMENT OF SURGERY,HTAR KLANG
SUMMARY OF CHEMOTHERAPY EXTRAVASATION INCIDENCE IN YEAR 2010 ( W3A/W3B/W4A/DAYCARE)

Month

NUMERATOR

DENOMINATOR

PERCENTAGE (%)

REPORTED AREA/ WARD

REMARKS

JAN FEB MAC APR MAY JUNE JULY AUG SEPT OCT NOV DEC

TOTAL
Nnad 010109

HTAR-SUR/ONCO/MNG-006

DEPARTMENT OF SURGERY,HTAR KLANG
STATISTIC OF CHEMOTHERAPY DEFAULTERS IN YEAR 2010 ( W3A/W3B/W4A/DAYCARE)

Month

NUMERATOR

DENOMINATOR

PERCENTAGE (%)

REPORTED AREA/ WARD

REMARKS

JAN 0 FEB 0 MAC 0 APR 0 MAY 0 JUNE 0 JULY AUG SEPT OCT NOV DEC 43 0% NA 62 0% NA 57 0% NA 55 0% NA 58 0% NA 49 0% NA

TOTAL
Nnad 010109

DEPARTMENT OF SURGERY,HTAR. CANCER NOTIFICATION 2010
S N TYPES OF CANCER STAGE

JAN 6 6 1 2 1 1

FEB 9 2 1

MAR 9 3 4 1 1 1

APR 12 3 6 2 2

MAY 4 4 1

JUNE 12 4 1

JULY 6 6 1

AUG 6 5 3 1

SEPT 9 1 2 2 1

OCT 12 2 1

NOV 8 1 2

DEC 2 2 1 1 1

TOT

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

CA.Breast Ca. Colon Ca.Rectum Ca. Stomach Ca. Esophagus Ca. Thyroid Ca.Pancreas Hepatoma/HepatoCellular Ca. Ca.Testis Ca.Renal Ca.Bladder Ca.Peritoneal Lymphoma: Hodgkin : Non-Hodgkin Ca. prostate Sarcoma Meningioma Cancer with unknown primary

3

2

Nnad010110

Nnad 010109