ROOM:
NAME:
ALLERGIES
MD
ADMITTING DX:
HX
CONSULTS
CODE:
RP:
DIET:
NEURO:
CV:
RESP:
GI:
GU:
SKIN:
ACTIVITY:
LABS:
Date
NA
K
CL
Hco3
BUN
CRT
GLU
WBC
HGB
HCT
PLT
PT
PTT
INR
CA
MG
XRAY
MEDS:
06 07 08 09 10 11 12 13 14 15 16 17 18
PRN:
FOLLOW Ups
RHYTHM:
REPORT:
NOTES