Davao Doctors College, Inc.

Gen. Malvar St., Davao City

College of Allied Health Sciences | Nursing Program
DRUG STUDY

Name of Patient:__________________ Date of Admission:_____________ Room#:______

Age:_____ Sex:_____ Civil Status:______________ Attending
Physician:_________________________

Date & Medication Mode of Action Dosage Indication/s Contraindicatio Side Adverse Nursing
Time ns Effects Effects Responsibilities
Ordered

BRAND Dose:
NAME:

ROUTE:
GENERIC
NAME:

FREQUE
NCY:

CLASSIFIC
ATION:

Reference:
 Davao Doctors College, Inc.
Gen. Malvar St., Davao City
College of Allied Health Sciences | Nursing Program

.
 Davao Doctors College, Inc.
Gen. Malvar St., Davao City
College of Allied Health Sciences | Nursing Program

RHEA ANNE A.
CRUZ NAME OF
STUDENT