NRS-C008-05-1

Lorma Medical Center

Carlatan, San Fernando La Union 2500

HOME CARE PLAN

Patient’s Name: Apilado, Maricar Date:10/11/14
Patient’s Data: Age:30 years old

I. ACTIVITY LEVEL:
Bed rest

II. DIET INSTRUCTIONS:

low salt diet

III. MEDICATIONS:
MEDICATION as INSTRUCTED.
IV. TREATMENT: Take medicine as prescribed by your physician

V. WHAT TO OBSERVE:
Chest pain, difficulty of breathing, sudden drop and increase of BP

VI. OTHER CONSIDERATIONS:

After one to two weeks, please expect to receive a call from Lorma
Telehealth Coordinator, Mrs. Juliet Puzon, for evaluation of care rendered,
compliance to health care plan, and other instructions given upon discharge
and for any other concern regarding your health.

VII. FOLLOW-UP WITH ATTENDING PHYSICIAN:

Name: Dr. Mardave Martinez Date: October 14, 2014

Received By: Date:10/11/14
Patient: Apilado, Maricar
Discharge Nurse:Annabelle Benavidez