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NURSING CARE PLAN GUIDE

NAME OF PATIENT: _____________________________AGE: ____SEX: _______ Name of Student: ________________________________________


CIVIL STATUS: ________ RELIGION: __________RM/BED NO. _______________ Area: _______________________Level /Block: _______________
ADDRESS: ______________________________________________________________ Date Submitted: _________________________________________
DATE OF ADMISSION: ______________DIAGNOSIS: ________________________ Rating: ________________________________________________

DATE CUES NURSING NURSING OBJECTIVES NURSING INTERVENTION RATIONALE EXPECTED


Subjective/Objective DIAGNOSIS OUTCOME

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