PATIENT FORM ADMISSION

Surname : Felidicia First name : Anneth

Gender : Female
DOB : 12 july 2002
Marital Status : married
Address : Houston Avenue, No. 15, Washington DC.
Occupation : Actress
Contact No. : 09786543098
Next of Kin : Mr. Herry (husband)
Alcohol Intake : None
Smoking Intake : None
Allergies : peanut
Reason for admission : Dizziness and high fever
Medical History : Hypertension
Nurse : Hello, good morning
Patient: Good morning, nurse
Nurse: What's your surname, please?
Patient: My surname is felidicia
Nurse: Okay, Now what's your first name?
Patient: My first name is Anneth
Nurse: Okay, What's your date of birth?
Patient: It's on twelve of july , nineteen
Nurse: I see. What do you do? What's your job?
Patient: I'm a Actress nurse
Nurse: What's your marital status?
Patient: I'm married nurse
Nurse : where do you live?
Patient : Houston Avenue, No. 15, Washington DC.

Dialogue of Patient Admission

Nurse: Who is your next of kin in this admission?
Patient: Mr. Herry, my husband
Nurse : Do you smoke? Or do you consume alcohol?
Patient : None
Nurse: Are allergic on something?
Patient : yes, nurse
Nurse : may i know what are you allergic to ?
Patient : peanut nurse
Nurse: Do you have any medical history?
Patient: Yes, nurse. I have a hypertension
Nurse: Okay, I see. Why do you come to the hospital What problem you have?
Patient : I have got a Dizziness and high fever, Nurse.
Nurse : Well. Thank you for your cooperation, I will consult
with the doctor in 10 minutes. And I will return to discuss it with you.
Then I'll excuse myself, thank you.
Patient : yes nurse you’re welcome