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Sample Kardex

The document is a kardex form from the Josefina Belmonte Duran Albay Provincial Hospital. It contains fields to record a patient's name, age, sex, hospital number, address, weight, blood type, bed number, classification, attending physician, diagnosis, dates of admission, operation, and delivery. It also includes sections to log medical treatments, laboratory tests, procedures, medicines, intravenous fluids, diet, vital signs, contraptions, and special needs over the course of the patient's hospital stay in 3 sentences or less.

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Maria
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2K views1 page

Sample Kardex

The document is a kardex form from the Josefina Belmonte Duran Albay Provincial Hospital. It contains fields to record a patient's name, age, sex, hospital number, address, weight, blood type, bed number, classification, attending physician, diagnosis, dates of admission, operation, and delivery. It also includes sections to log medical treatments, laboratory tests, procedures, medicines, intravenous fluids, diet, vital signs, contraptions, and special needs over the course of the patient's hospital stay in 3 sentences or less.

Uploaded by

Maria
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Kardex Patient Information Form: This section contains a structured form used for recording patient information, medical data, and daily care notes within a healthcare facility.

Republic of the Philippines

Province of Albay
JOSEFINA BELMONTE DURAN ALBAY PROVINCIAL HOSPITAL
PHIC Accredited Health Care Provider
Tuburan, Ligao CIty

KARDEX
Name: Age: Sex: Hospital Number:

Address: Wt: Blood Type: Bed No.:

Classification:

Service/Attending Physician:
Diagnosis: Date of Admission:

Operation: Date or Operation:


Date of Delivery:
Date Date Medical Medicines Date Date
Ordered D/C Treatment/Laboratory/ Ordered D/C
Procedures

Diet

I. V. Fluid

I. V. Fluid TF

Side
Drip/BT:

Vital Signs

Contraptions
:

Special
Needs:

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