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  • Booking Form

    Uploaded by

    Lou Alounkone
    43 views1 page
    This operating theatre booking form collects information about a patient requiring surgery including their name, date of birth, gender, location, parents' contact details, name of surgeon, type of operation, proposed date and time, urgency classification, and confirmation that the surgeon, anesthetist, and parents have been informed. It requests that after booking the patient, the form should be brought to the operating theatre.

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    This operating theatre booking form collects information about a patient requiring surgery including their name, date of birth, gender, location, parents' contact details, name of surgeon, type of operation, proposed date and time, urgency classification, and confirmation that the surgeon, anesthetist, and parents have been informed. It requests that after booking the patient, the form should be brought to the operating theatre.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    43 views1 page

    Booking Form

    Uploaded by

    Lou Alounkone
    This operating theatre booking form collects information about a patient requiring surgery including their name, date of birth, gender, location, parents' contact details, name of surgeon, type of operation, proposed date and time, urgency classification, and confirmation that the surgeon, anesthetist, and parents have been informed. It requests that after booking the patient, the form should be brought to the operating theatre.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    Operating theatre

    Booking Form
    Patient
    Patient name ID

    Date of birth / age Gender Male / female

    Patient’s location OPD/home IPD/Bed ER/ NIC/ ONIC


    Bed
    Name of parents and
    contact phone
    number
    Name of surgeon

    Type of Operation

    Proposed date and


    time of operation

    Circle appropriate Emergency Urgent Elective Day case


    description

    Booking
    confirmation by

    Theatre Manger or
    delegate

    Confirmed date and


    time of operation

    Surgeon Informed Yes/No Anaesthetist Yes/No Parents Yes/No


    informed informed

    (After you book patient please bring it to OT)


    vandee

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