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GRAPHIC CHART

Name of Patient: Jessy Villa Ward/Room: Male Address: Mandalagan, Bacolod City
Age: 20 years old Sex: Male Admission Date: September 04, 2022

Date September 05, 2022


Hospital Days 2 days
Post-Op/Post-
Partu
AM PM AM PM AM PM
Hour 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12
Pulse
Rate

Tempera
ture
150

140
40.0

130

120 39. 0

110

100 38.0

90

80 37.0

70

60 36.0

50 35.5

Respirations 21 20
bpm bpm
Blood Pressure 110/80 110/70
mmhg mmhg

Weight 65 kg 65 kg
7a-3p 3p-11p 11p-7a TOTAL 7a-3p 3p-11p 11p-7a TOTAL 7a-3p 3p-11p 11p-7a TOTAL
Diet
Intake: Oral
Parenteral
TOTAL INTAKE
Urine (cc)/ No, of Tim
Drainage
Emesis
TOTAL OUTPUT
Stool/ No. of Times
(Name, Middle,

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