Laguna State Polytechnic University

Main Campus
Sta. Cruz, Laguna

COLLEGE OF NURSING

OPERATING ROOM
WRITE-UP
MAJOR OPERATIONS
Name of Student:
Name and Address of School:
Year of Admission on the Bachelor of Science in Nursing Program:
Number: Name of Patient:
Date of Operation: Diagnosis:
Case Number: Operation Performed:

Type of Anesthesia: Name of OR Scrub Nurse:

Name of Surgeon:
Hospital Name: Name of Clinical Instructor:

PATIENT’S HISTORY

PATHOPHYSIOLOGY

PROCEDURE

DRAWING OF INSTRUMENTS (At the back)