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  • Case Slip Colored

    Încărcat de

    John Dale Marzo
    25 vizualizări2 pagini

    Titlu original

    case slip colored

    Drepturi de autor

    © Attribution Non-Commercial (BY-NC)

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    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca DOC, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    25 vizualizări2 pagini

    Case Slip Colored

    Încărcat de

    John Dale Marzo

    Drepturi de autor:

    Attribution Non-Commercial (BY-NC)
    Descărcați ca DOC, PDF, TXT sau citiți online pe Scribd
    Indicator pentru conținut neadecvat
    din 2

    Baguio Central University Name of Baby:

    COLLEGE OF NURSING AND SCHOOL OF _________________________________


    MIDWIFERY Gender: _________________
    #28 Lower P.Burgos St., Baguio City Admitting Diagnosis:
    ______________________________
    DELIVERY CASE SLIP ________________________________________________
    ________________________________________________
    Name of Hospital: ________________________________________________
    ______________________________ Final Diagnosis:
    Name of Student: ___________________________________
    ______________________________ ________________________________________________
    Course: _BSN_ Year: _IV_ Section: ______ ________________________________________________
    Case No. : __________ Shift: ________ ________________________________________________
    Actual: _______ Assist: _______ Cord tie: Obstetrician:
    _______ _____________________________________
    Name of Mother: Pediatrician:
    ______________________________ _____________________________________
    Address: _____________________________________ Staff Nurse:
    Gravida: __________ Para: _________ Type: ______________________________________
    ________ License No. :
    Date of Delivery: ___________ Time: _____________________________________
    ______________ Clinical Instructor:
    Name of Baby: ________________________________
    _________________________________ License No. :
    Gender: _________________ _____________________________________
    Admitting Diagnosis:
    ______________________________
    ________________________________________________
    ________________________________________________ Baguio Central University
    ________________________________________________ COLLEGE OF NURSING AND SCHOOL OF
    Final Diagnosis: MIDWIFERY
    ___________________________________ #28 Lower P.Burgos St., Baguio City
    ________________________________________________
    ________________________________________________ DELIVERY CASE SLIP
    ________________________________________________
    Obstetrician: Name of Hospital:
    _____________________________________ ______________________________
    Pediatrician: Name of Student:
    _____________________________________ ______________________________
    Staff Nurse: Course: _BSN_ Year: _IV_ Section: ______
    ______________________________________ Case No. : __________ Shift: ________
    License No. : Actual: _______ Assist: _______ Cord tie:
    _____________________________________ _______
    Clinical Instructor: Name of Mother:
    ________________________________ ______________________________
    License No. : Address: _____________________________________
    _____________________________________ Gravida: __________ Para: _________ Type:
    ________
    Date of Delivery: ___________ Time:
    ______________
    Baguio Central University Name of Baby:
    COLLEGE OF NURSING AND SCHOOL OF _________________________________
    MIDWIFERY Gender: _________________
    #28 Lower P.Burgos St., Baguio City Admitting Diagnosis:
    ______________________________
    DELIVERY CASE SLIP ________________________________________________
    ________________________________________________
    ________________________________________________
    Name of Hospital:
    Final Diagnosis:
    ________________________________
    ___________________________________
    Name of Student:
    ________________________________________________
    ______________________________
    ________________________________________________
    Course: _BSN_ Year: _IV_ Section: ______
    ________________________________________________
    Case No. : __________ Shift: ________
    Obstetrician:
    Actual: _______ Assist: _______ Cord tie:
    _____________________________________
    _______
    Pediatrician:
    Name of Mother:
    _____________________________________
    ______________________________
    Staff Nurse:
    Address: _____________________________________
    ______________________________________
    Gravida: __________ Para: _________ Type:
    License No. :
    ________
    _____________________________________
    Date of Delivery: ___________ Time:
    ______________
    Clinical Instructor:
    ________________________________
    License No. :
    _____________________________________

    Baguio Central University


    COLLEGE OF NURSING AND SCHOOL OF
    MIDWIFERY
    #28 Lower P.Burgos St., Baguio City

    DELIVERY CASE SLIP

    Name of Hospital:
    ________________________________
    Name of Student: _
    _____________________________
    Course: _BSN_ Year: _IV_ Section: ______
    Case No. : __________ Shift: ________
    Actual: _______ Assist: _______ Cord tie:
    _______
    Name of Mother:
    ______________________________
    Address: _____________________________________
    Gravida: __________ Para: _________ Type:
    ________
    Date of Delivery: ___________ Time:
    ______________
    Name of Baby:
    _________________________________
    Gender: _________________
    Admitting Diagnosis:
    ______________________________
    ________________________________________________
    ________________________________________________
    ________________________________________________
    Final Diagnosis:
    ___________________________________
    ________________________________________________
    ________________________________________________
    ________________________________________________
    Obstetrician:
    _____________________________________
    Pediatrician:
    _____________________________________
    Staff Nurse:
    _____________________________________
    License No. :
    _____________________________________
    Clinical Instructor:
    ________________________________
    License No. :
    _____________________________________

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