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: