INCIDENT REPORT

Name of staff: Mrs. Suhasini Barfe

Incidence place: Operation Theater.

Date of incident: 16/10/2022

Time: 11 am

Type of incident: post operational heavy bleeding.

Mrs. Suhasini Barfe posted in Operation Theater during herMorning duty patient Mrs.

SabaleArchana 33 years old female patient starting heavy bleeding after laparotomy.Sister had

informed to doctor regarding the incident. Doctor was take immediate implementing care to

reduce bleeding.

The occurred incident was been informing to the ward In-charge sister Mrs.

Rajlaxmiand the departmental supervisor and record the incidence.

Signature:

Date:

Time:
 NIGHT REPORT

Date: 3/10/2022Trans in: 02. Shift: Night

Day: Monday. Trans Out: 04 Previous Day Patient No: 07.

Capacity: 10 bed Discharge00 Total patient: 06

Patient Bio data Treatment

Name : Mrs.ShakuntalaDevidasShinde This patient was trans in from female

surgery ward to surgical ICU as dated on
Age /sex : 42years /female.
29/9/2022 at 6 pm with the chief complaints of
IPD no- :20003258 pain in knee joints. Patient seen by Dr.
Bhalerao sir as being HOD of TKR department.
OPD no : 20025818
Now patient stable with treatment.
Date of admission: 1/10/2022.
Dr.unit :I Treatment :
Diagnosis: TKR
Vital sign : Tb. Dolenzen H 40mg.-------Bd
Tb. Restyl 0.25mg ------------Hs.
Time T P R BP Cap. Autrin -----------------od.
Tb.folvit 5 mg---------------od.
10 Pm 98.7 102/m 24/m 95/68
6Am 98.0 90/m 20/m 110/70

In-charge sign: