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JMJ Marist Brothers

Notre Dame of Marbel University


College of Arts and Sciences – Nursing Department
Alunan Avenue, Koronadal City, South Cotabato

Patient’s Name: ______________________________________________________________________________________Age:_______________________Sex:______________________


Chief Complaints:____________________________________________________________Diagnosis:_____________________________________________________________________
Date Admitted:______________________________________

ASSESSMENT CUES NEEDS NURSING DIAGNOSIS BACKGROUND NURSING OBJECTIVES INTERVENTIONS RATIONALE EVALUATION
INFORMATION
Independent:
Subjective:

Objective:

Dependent:

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