SURNAME: AGE: 32 HOSPITAL NO.

/__/__/__/__/__/
Du
GIVEN NAME: SEX  WARD NO.
Michele [] M   [✓] F
DOCTORS’ ORDER/ NURSES COMPLIANCE SHEET
(Authenticate all orders)
C – Carried                   A – Administered                  R – Request Made
           E – Endorsed                                    D - Discontinue

ORDER Time 
Date C A R E D Posted
Time Signature
March 17, 2021 - Please admit under the service of Dr.
7:30am
LU ---------------------------------------- ✓ ✓

- Consent to care -------------------------

✓
- NPO when in active labor ------------
✓
- Start venoclysis with D5LR iL:
incorporate 10 units of oxytocin to ✓ ✓
run at 30gtts/min -----------------------
Diagnostics / Laboratories:
- CBC, BT and platelet count -------- ✓
- Urinalysis -------------------------------
✓
- Hooked to EFM ------------------------
✓
- Monitor Fetal Heart Tone (FHT)
every hour and monitor progress of ✓ ✓
labor -------------------------------------
- V/S q 4H --------------------------------
✓ ✓
- Refer accordingly ---------------------
✓ ✓
 J.

Bisnar Clint Mikael H Eulatriz

Dr.
Bisnar 8:30 AM