Mindanao State University

College of Medicine
Department of Obstetrics & Gynecology
OUT-PATIENT SERVICE GRADING SHEET
NAME OF CLERK ___________________________________
NAME OF PATIENT

Hx
25%

PE
25%

Dx
25%

DATE OF ROTATION
Mx
25%

GRAD
E

________________

SIGNATURE

DATE

Note:

This sheet is to be presented to the OPD consultant for grading upon presentation of a
new case. Each clerk should have a minimum of 3 grades before the end of his/her
GTLMH rotation.
At the end of the rotation, this sheet is to be submitted together with the performance
sheet to the Chief of Section for proper evaluation.
This grading sheet should remain clean. Erasures are discouraged.
Do not lose this record. In case of loss, the graded discussion will have to be repeated.