BP SHEET

Name: ________________________________ Ward: ________ Room No.: __________ Bed No.

_________

Date Time BP Initial Date Time BP Initial

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.