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  • Clinic Pass

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    Lealyn Dimaano Ordinario
    115 views1 page
    This document contains a template for tracking student visits to a school clinic. The template includes fields for student name, date, time, parent contact number, chief complaint, referring teacher, time in and out of the clinic, and action taken. There are columns for two students per page and the template is repeated for multiple pages.

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    CLINIC-PASS

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    This document contains a template for tracking student visits to a school clinic. The template includes fields for student name, date, time, parent contact number, chief complaint, referring teacher, time in and out of the clinic, and action taken. There are columns for two students per page and the template is repeated for multiple pages.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    115 views1 page

    Clinic Pass

    Uploaded by

    Lealyn Dimaano Ordinario
    This document contains a template for tracking student visits to a school clinic. The template includes fields for student name, date, time, parent contact number, chief complaint, referring teacher, time in and out of the clinic, and action taken. There are columns for two students per page and the template is repeated for multiple pages.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    CLINIC CLINIC

    STUDENT NAME: PASS STUDENT NAME: PASS


    DATE: TIME: DATE: TIME:
    PARENT CONTACT NUMBER: PARENT CONTACT NUMBER:
    CHIEF COMPLAINT: CHIEF COMPLAINT:

    TEACHER: TEACHER:

    TIME IN: TIME OUT: TIME IN: TIME OUT:


    ACTION TAKEN: ACTION TAKEN:

    CLINIC CLINIC
    STUDENT NAME: PASS STUDENT NAME: PASS
    DATE: TIME: DATE: TIME:
    PARENT CONTACT NUMBER: PARENT CONTACT NUMBER:
    CHIEF COMPLAINT: CHIEF COMPLAINT:

    TEACHER: TEACHER:

    TIME IN: TIME OUT: TIME IN: TIME OUT:

    ACTION TAKEN: ACTION TAKEN:

    CLINIC CLINIC
    STUDENT NAME: PASS STUDENT NAME: PASS
    DATE: TIME: DATE: TIME:
    PARENT CONTACT NUMBER: PARENT CONTACT NUMBER:
    CHIEF COMPLAINT: CHIEF COMPLAINT:

    TEACHER: TEACHER:

    TIME IN: TIME OUT: TIME IN: TIME OUT:

    ACTION TAKEN: ACTION TAKEN:

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