INTAKE & OUTPUT MONITORING SHEET

SURNAME: bautista M.I.: A AGE: 58 HOSPITAL NO.: 2021-0000025

GIVEN NAME: milagros SEX: f WARD/ROOM NO.: medical ward-207

INTAKE OUTPUT
Date Time Shift IVF Oral/NGT TOTAL Urine Drain TOTAL
01-05- 3:00 7-3 850 ml 1500 ml 2350 ml 1450ml 0 1450 ml
2021 pm
01-05- 11:00 3-11 950 ml 1250 ml 2200 ml 1900 ml 1x stool 1900 ml
2021 pm
01-05- 7 am 11-7 1100 ml 0 1100 ml 550 ml 0 550 ml
2021
5650 ml 3100 ml
01-06- 3:00 7-3 700 ml 2050 ml 2750 ml 2180 ml 0 2180 ml
2021 pm
01-06- 11:00 3-11 800 ml 1750 ml 2200 ml 2030 ml 2x stool 2030 ml
2021 pm
01-06- 7 am 11-7 800 ml 1450 2250 ml 1120 ml 1x stool 1120 ml
2021
7550 ml 5330 ml
01-07- 3:00 7-3 750 ml 1530 ml 2280 ml 2430 ml 5x stool 2430 ml
2021 pm
01-06- 11:00 3-11 750 ml 920 ml 1670 ml 2330 ml 1x stool 2330 ml
2021 pm
01-06- 7 am 11-7 750 ml 930 ml 1680 ml 1640 ml 0 1640 ml
2021
5630 ml 6400 ml