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  • MCH Emergency Department: Male Female

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    maitham
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    This document appears to be a template for recording patient information during an emergency department visit. It collects details such as gender, age, chronic conditions, past and current diagnoses, number of prior visits, reason for revisits, type of previous education provided, socioeconomic status, time of prior visits, family education level, triage level, and patient disposition after the visit. The template contains checkboxes and spaces to document this clinical information for patient visits.

    Original Description:

    resaadf

    Original Title

    ER Researsh

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    This document appears to be a template for recording patient information during an emergency department visit. It collects details such as gender, age, chronic conditions, past and current diagnoses, number of prior visits, reason for revisits, type of previous education provided, socioeconomic status, time of prior visits, family education level, triage level, and patient disposition after the visit. The template contains checkboxes and spaces to document this clinical information for patient visits.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views1 page

    MCH Emergency Department: Male Female

    Uploaded by

    maitham
    This document appears to be a template for recording patient information during an emergency department visit. It collects details such as gender, age, chronic conditions, past and current diagnoses, number of prior visits, reason for revisits, type of previous education provided, socioeconomic status, time of prior visits, family education level, triage level, and patient disposition after the visit. The template contains checkboxes and spaces to document this clinical information for patient visits.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    MCH Emergency Department

    File No. : Date :

    1. Gender: Male Female

    2. Age:
    3. Chronic Disease:
    4. Previous Diagnosis:
    5. Current Diagnosis:

    6. How many visits:


    1 2 3 4 5

    7. Reason of Revisit: Same New

    8. Did Education done previously? Yes No


    If yes, what kind of education.

    Verbal Video Written

    Verbal & video Verbal &written Video &written

    9. Socioeconomic status (Insurance): Yes No

    10.Time of previous visit:


    7-3 3-11 11-7 Weekday Weekend

    11.Level of family education:

    12.Level of triage ‘first visit’:

    1 2 3 4 5

    13.Disposition of the patient after the visit:


    Home Admission ‘Ward’or’PICU’ Death

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