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KARDEX

ADD: WT.
Last Name First Name Middle Birth date Age Religion Date Admitted Case No. Room RTPCR

VACCINATION STATUS
Chief Complaint/Diagnosis COMORBS: Attending Physician

Date Medications: Date # Parenteral Fluid/Blood Remarks

Date Diagnostic Procedures Date Referrals Remarks

SPECIAL ENDORSEMENTS DIET:


02 SUPPORTSET UP HD dates BT

RBS COMPLETED CYCLES:

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