ADMISSION

ATHIA FIDIAN, M.PD

ADMISSION
 Before entering a hospital, a patient is given an
admission form. It is used to obtain information
about case history, in order to determine a patient
goes to appropriate ward.
EXPRESSIONS IN GIVING ADMISSION
 Welcome, Mr. Harry
 I’ll show you your room, now.
 I’d like to ask you some questions.
 Have you ever been in a hospital?
 When was the last time you were hospitalized?
 Have you had any operation?
 Are you allergic to anything?
 Do you use hearing aid?
 Do you smoke? How many cigarettes in a day?
 Could you tell me about your illness?
 What medicine have you taken at home?
 Do you want a religious service?
WHEN ADMITTING THE PATIENT AT LEAST YOU HAVE SOME OF THESE PATIENTS’ DATA:

 Complete name
 Address & phone number
 Date of the birth
 Civil state (status)
 Occupation
 Religion
 Name and address of next kin (sanak saudara)
 History of the patient
A CASE TO STUDY
 JA 37 years old woman, was the mother of five
children, and the wife of RA, a carpenter in
Illinois. RA lives at 115 Riverview, Middletown,
Ph.312 437 6677. JA was referred by her family
physician, Dr. Scott to the continence clinic at St
James’ Medical Center 30 miles from her house.
ADMISSION FORM
St. James Medical Center Admission Card Hospital Reg. No :
Ward/Dept :
SURNAME (IN BLOCK LETTERS) FIRST NAME
. What’s your surname? . What’s your first name?
. How do you spell it, please? . How do spell it?
. Name, please!
ADDRESS & TELEPHONE NO. DATE OF BIRTH
. Where do you live? . When were you born?
. Your phone number? . Your date of birth, please.
CIVIL STATE OCCUPATION
Married (in the case of a child, father’s occupation)
Single . What’s your occupation?
Widowed . What’s his father occupation?
Other
RELIGION NAME & ADDRESS OF NEXT OF KIN
. What’s your religion? . Who’s your nearest relative?
. Your next of kin?
. Do you live at the same address?
TELEPHONE NO
( If no phone, give a number where messages
may be sent. Add ‘message only’)
. Whom can I give message?