PMC American Hospital CLINICAL CHART Consultant a Patai Clatty
Date :21223
Name_u-aeinAge/Sex 82:!/4 Bed2r IPD No.9829
BP TEMP RESP SPO, OTHER| SIGNATURE REMARK
TIME PULSE
eoTHS-T4
Yashy
3122
tonhy
Date:
TIME PULSE B.P. TEMP RESP SPO, OTHERsIGNATURE REMARK
2:3 /6s8.2-f of8-.
pur98 min
Yas
12268 Poona
A
Teent
Teena
Date: 2l2123
B.P. TEMP RESP SPO, OTHER SIGNATURE REMARK
TIME PULSE
Teeng
RRICAMA
3 Indrs ViIna
limel bor The Ne nig AssnCe Co. Ltel. undee
YILTNX INDLA TECHNDLOGYy sERnCES POLICY
PMC American Hospital CLINICAL CHART Consultant D
Date: 22l2
Name Rony ga Age/Sex. Bed_2 r IPD No. 9g9
TIME PULSE B.P. TEMP RESP SPO,OTHER SIGNATURE REMARK
2 sA Yashu
l32
|128 i 8-14|
|3A
TIME Date:
PULSE B.P. TEMP RESP SPO, OTHER SIGNATURE REMARK
94'"Phbi
|28/4
SAm 122]mi 3$2 56|mi 91
TIME PULSE Date
B.P. TEMP RESP SPO, OTHER SIGNATURE REMARK
EICAN,HOg
nora
claimed hrThe Nes Jnelia Asswesn ce co. Ltd.
XTLINX INDIA TECHNOLOGy SERViCES unde
POLiy.
PMC American Hospital NTAKE/ OUTPUT CHART Consultant
IPD No. 14822
Name k Shanuan Age/Sex, Bed
OUTPUT
DATE INTAKE
DRAIN /OTHERS
START ORAL/OTHERS TIME URINE
LV. FLUIDS TIME
TOTAL OUTPUT
TOTAL INTAKE
IPD No.
Age/Sex Bed
Name.
OUTPUT
DATE
|INTAKE
START URINE DRAIN /OTHERS
ORAL/OTHERS TIME
L.V.FLUIDS TIME
CA
ERIC
PMC
324005
dta
yine
CR131
TOTAL OUTPUT
TOTAL INTAKE
Claime tor The Ne tndia Assweynce co.Ltd urds xILI NX
TNDIA TECHNOLOCy SERYUES fOLI CY
claimel #r the Ned rha Assetnce Co. Ltd.
unden- t N XI LIN INDIA TECHNODa
SERIVCES POLLcy,
PMC American Hospital NTAKEIOUTPUTCHART Consultant.
Name Ro Rnu Ja. Agel/Sex . Bed IPD No.
DATE Ja3 INTAKE OUTPUT
LV. FLUIDS START
TIME ORAL/OTHERS TIME URINE DRAIN/OTHERS
19g0 P
TOTAL INTAKE
TOTAL OUTPUT
Name Bn Ranu jeio AgelSex PclaIM Bed IPD No.
DATE3|A 23 INTAKE OUTPUT
1.V. FLUIDS START
TIME ORAL/OTHERS. TIME URINE DRAIN / OTHERS|
JAM
Pae
pasen
CANHOSPI
A
TOTAL INTAKE 8toTAL OUTPUT
CA13 indra
PMC American Hospital NTAKE/OUTPUT CHART Consultant 2 vieK Dupta
Name/é Aeneaisi Age/Sex 3cla Bed _ IPDNo.1812
DATE INTAKE OUTPUT
LV. FLUIDS START URINE DRAIN/ OTHERS
TIME
ORAL/OTHERS TIME
9,3b4
TOTAL INTAKE TOTAL OUTPUT
Bed IPD No.
Name Age/Sex
DATE INTAKE OUTPUT
START ORAL/OTHERS URINE DRAIN/OTHERS
LV. FLUIDS TIME
TIME
PI
TOTAL INTAKE TOTAL OUTPUT
reeimeo es The Nes Indha Assuance co.Ltel. nde XTLINY
INDIA TECHNDLb4y SERVICES POLI cy
Cleumel toy 1he Ne
Undes XILINX TNDIAtrlia Acsubance Ce.ltH
SERVTES POLICy TECHNOLOGY
PMGAmerican Hospital DRUG-SHEET Consultant2 Aajzn cheth
Name M2R a in Age/Sex32fBed23 IPD No 22
Drugs Date 14223
Teena
Tabe Rahlet.R
Becasule 2
Teeh
CP-13 ndra
vi
Ne) Inoia Ass09nce to, Lel.
Claimel he LOGY SERVI CES
4nder XI LINX JNDIA TECHNO
PoLICY.
Drugs DatehJH2-5
Ron
Hecen TAY
Talo Raklet 80
Reny
Slataapouduu
tenineal
Leeno
hourzlg
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tindo Xt LINY LNDIA TE CHNDLODY
cERVICES POL1
Drugs patei2H2-2gh
Time Time Time Time
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Seale
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deiglst t&fots
BiathTine!2
842Prn
TNDI
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Name PMG
AmericanTeCHNDLOGY
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RantacLAnn 5 Aþos
DRUG-SHEET
Drugs Hospital StRYI
xtLINY
apan /-LBed2
Age/SexAoy CES
Consul
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TIme
22]23Date
Time
NO.&20IPD
Time
Time
