REGION II TRAUMA AND MEDICAL CENTER

Bayombong, Nueva Vizcaya

EMERGENCY DRUG MONITORING SHEET

For the Month of ____________________

Name of Drug QTY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

1

10

11

12

13

14

15

OPD_Form_ECB_2020
 Signature

REGION II TRAUMA AND MEDICAL CENTER

Bayombong, Nueva Vizcaya

EXPIRATION DATE MONITORING SHEET

For the Month of ____________________

1 17

2 18

3 19

4 20

5 21

6 22

7 23

8 24

9 25

10 26

11 27

12 28

13 29

14 30

OPD_Form_ECB_2020
15 31

16

OPD_Form_ECB_2020