MEDICATION TICKETS

(label and color)

MEDICATION TICKET
Ward/Room #: COVID Wing PIW
Name: ____Zack Tabudlo__________________________________________
Medicine: ________Piperacillin + Tazobactam__________________
_______________________________________________________________
Dosage: ______________390mg_____________________
Frequency: _____________Q6______________________________________________
Route: ___________IVTT__________________________________________

Date: __04/20/2021__________
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
04/20/2021 4:20PM
NOD Signature Over Printed Name

MEDICATION TICKET
Ward/Room #: COVID Wing PIW
Name: ____Zack Tabudlo__________________________________________
Medicine: ________Paracetamol__________________
_______________________________________________________________
Dosage: ______________100mg_____________________
Frequency: _____________Q4PRN__________________________________________
Route: ___________IVTT__________________________________________

Date: __04/20/2021__________
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
04/20/2021 4:20PM
NOD Signature Over Printed Name
 MEDICATION TICKET
Ward/Room #: COVID Wing PIW
Name: ____Zack Tabudlo__________________________________________
Medicine: ________Carbamazipine 100mg/5ml syrup__________________
_______________________________________________________________
Dosage: ______________2.5ml_____________________
Frequency: _____________BID__________________________________________
Route: ___________p.o.__________________________________________

Date: __04/20/2021__________
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
04/20/2021 4:20PM
NOD Signature Over Printed Name

MEDICATION TICKET
Ward/Room #: COVID Wing PIW
Name: ____Zack Tabudlo__________________________________________
Medicine: ________Baclufen 10mg/tab__________________
_______________________________________________________________
Dosage: ______________1/2 tab_____________________
Frequency: _____________TID__________________________________________
Route: ___________p.o.__________________________________________

Date: __04/20/2021__________
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
04/20/2021 4:20PM
NOD Signature Over Printed Name
 MEDICATION TICKET
Ward/Room #: COVID Wing PIW
Name: ____Zack Tabudlo__________________________________________
Medicine: ________Valproic Acid 250mg/5ml__________________
_______________________________________________________________
Dosage: ______________1.4ml_____________________
Frequency: _____________BID__________________________________________
Route: _____________________________________________________

Date: __04/20/2021__________
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
04/20/2021 4:20PM
NOD Signature Over Printed Name

MEDICATION TICKET
Ward/Room #: COVID Wing PIW
Name: ____Zack Tabudlo__________________________________________
Medicine: ________Amikacin__________________
_______________________________________________________________
Dosage: ______________105mg_____________________
Frequency: _________OD x 7days__________________________________________
Route: ___________IVTT__________________________________________

Date: __04/20/2021__________
Chua, Marielle P./Pegarro, KG.
NDU BSN 2 NDU CI
04/20/2021 4:20PM
NOD Signature Over Printed Name