DOCTOR’S ORDER/NURSES COMPLIANCE SHEET

(AUTHENTICATE ALL ORDERS)

Notre Dame Hospital PATIENT’S NAME: ROOM/WARD:
AND SCHOOL OF MIDWIFERY
EMERGENCY ROOM
Rosary Heights, Cotabato City
HILOT, EVA
PHYSICIAN:DR.
TOLENTIONO

C – CARRIED A – ADMINISTERED R – REQUEST MADE E – ENDORSED D – DISCONTINUED

DATE/TIME PROGRESS ORDER C A R E D TIME POSTED

NOTES SIGNATURE
10/12/20 - Secure consent to care / /
8am - NPO temporarily / /
- for CBC / / /
- D5LR 1L at 20gtts/min

/ / /

10/13/20 - IVF TF : D5LR 1L at SR / / /

8AM - DAT / /
- Mefenamic acid 500mg, po prn for pain Q6H / / /

10/14/20 - IVF to follow : D5LR IL at 20gtts /min / / /

8AM - start Prolacta 1 cap po, OD / / /
- Monitor I & O q shift / /
- encourage to BF

/ /