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MEDICATION TREATMENT SHEET

Last Name: First Middle Name: Date Admitted: Room No. Bed No. Hosp. No.
Name:
P.K 01/04/2021 107 12 2000350
Attending Physician: Co-Manage Physician: Age: Sex C.S.
Dra. Eli Tacad, MD 18 Male Single
Date
Medication Date Date Date Date Date Date Date
Ordered Dose Route Freq. Time
30
AM
750 min. 01/04/2021
01/04/2021 Cefuroxime IV PM
mg prior N 9:00 am
to OR
AM
750 01/04/2021
01/04/2021 Cefuroxime IV Q8 PM
mg N 10:30 am
Q6 x AM
30 01/04/2021
01/04/2021 Ketorolac IV 24 PM
mg N 10:30 am
hours
AM
50
01/04/2021 Tramadol IV PRN PM
mg N
AM
PM
N
AM
PM
N
AM
PM
N
AM
PM
N
DATE ORDERED TREATMENT Freq Time Date Date Date Date Date Date Date

Oxygen support via nasal cannula 10:30


O1/04/2021 01/04/2021
at 2Lpm am

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