Name: ____________________________________ Interpretation/ECG Diagnosis:

Roll #: __________
Name: ____________________________________
Date:____________________
Roll #: __________ Date: ___________________
STATION 1
STATION 1
Rate:
Rate:
Rhythm:
Rhythm:
PR interval:
PR interval:
QRS interval:
QRS interval:
Axis:
Axis:
QT:
QT:
QTc:
QTc:
Interpretation/ECG Diagnosis:
Interpretation/ECG Diagnosis:

STATION 2
STATION 2
Rate:
Rate:
Rhythm:
Rhythm:
PR interval:
PR interval:
QRS interval:
QRS interval:
Axis:
Axis:
QT:
QT:
QTc:
QTc:
Interpretation/ECG Diagnosis:
Interpretation/ECG Diagnosis:

STATION 3
STATION 3
Rate:
Rate:
Rhythm:
Rhythm:
PR interval:
PR interval:
QRS interval:
QRS interval:
Axis:
Axis:
QT:
QT:
QTc:
QTc:
Interpretation/ECG Diagnosis: