BP SHEET

Name: _______Marites_______________ Ward: __ER__ Room No.: ___1_____ Bed No. __1___

Date Time BP Initial Date Time BP Initial

09/19/ 10 am 143/89 Mejia C
20 mmHg
Legend: R-Refused, D-Dislodged, DC-Discontinued, OP-Out on Pass, P-Prescribed, E-Emesis, NPO-Including Meds
Effectivity Date: 03/04/2020 REV. No.: 02 GCGMH-F-NUR-18
This form is used for educational purposes only and with approval from the concerned agency. Strictly not for reproduction.