THERAPEUTIC SHEET

Date Medication/ Dosage/ SHIFT DATE

Ordered Frequency/ Route 10/07/2022 10/08/2022
October 07, Medication: zinc sulfate 12-8
2022 Dose: 0.5 ml 8-4 10am
Frequency: OD
4-12 10pm
Route: PO

October 07, Medication: Bacillus 12-8 6am

2022 clausii (Erceflora) 8-4 10am
Dose: 5 ml
6pm 10pm
Frequency: BID 4-12
Route: PO
October 07, Medication: Paracetamol 2am/6am
2022 Dose: 0.8 ml IVTT
12-8
Frequency: q4h
Route: PRN

8-4 10am/2pm 1am/2pm

4-12 6pm/10pm 6pm/10pm

12-8

8-4

4-12

12-8

8-4

4-12

12-8

8-4

4-12

12-8

8-4

4-12
Name: Mara K. Halili _ Age: 4 months old Sex: Female Ward: Pedia Ward Bed No.: 1 Hosp. No. 8866432-2022
Specimen Signature:
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Legend: R-Refused, D-Dislodged, DC-Discontinued, OP-Out on Pass, P-Prescribed, E-Emesis, NPO-Including Meds
Effectivity Date: 03/04/2020 REV. No.: 02 GCGMH-F-NUR-13
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