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NURSES NOTES

IDENTIFICATION DATA
Name Age Sex Religion Diagnosis Registration Number
Date Time T.P.R B.P

: : : : : :
Stool Name of the Medicine

Ward Bed Number Date of Admission Date of Operation Date of Discharge Under Doctor
Medication
Dose Route Time

: : : : : :
Time Nursing Action
Remarks Signature

Urine

Oral Intake/I.V.fluid
Time Type of Diet Amount

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