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    Operating Room Record

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    Anna Margarett Mutia Caballar
    The document is an operating room record form from the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in Ozamiz City, Philippines. It collects information about a patient's name, age, sex, civil status, ward, bed number, hospital number, pre-operative and post-operative diagnoses, surgeons, anesthesiologists, anesthesia used, date and times of operation and anesthesia, surgical procedure performed, and whether tissue was sent to the laboratory. The surgeon signs at the bottom.

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    Operating Room Record

    Uploaded by

    Anna Margarett Mutia Caballar
    8 views1 page
    The document is an operating room record form from the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in Ozamiz City, Philippines. It collects information about a patient's name, age, sex, civil status, ward, bed number, hospital number, pre-operative and post-operative diagnoses, surgeons, anesthesiologists, anesthesia used, date and times of operation and anesthesia, surgical procedure performed, and whether tissue was sent to the laboratory. The surgeon signs at the bottom.

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    OPERATING ROOM RECORD.docx

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    The document is an operating room record form from the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in Ozamiz City, Philippines. It collects information about a patient's name, age, sex, civil status, ward, bed number, hospital number, pre-operative and post-operative diagnoses, surgeons, anesthesiologists, anesthesia used, date and times of operation and anesthesia, surgical procedure performed, and whether tissue was sent to the laboratory. The surgeon signs at the bottom.

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    © All Rights Reserved
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    8 views1 page

    Operating Room Record

    Uploaded by

    Anna Margarett Mutia Caballar
    The document is an operating room record form from the Mayor Hilarion A. Ramiro Sr. Regional Training and Teaching Hospital in Ozamiz City, Philippines. It collects information about a patient's name, age, sex, civil status, ward, bed number, hospital number, pre-operative and post-operative diagnoses, surgeons, anesthesiologists, anesthesia used, date and times of operation and anesthesia, surgical procedure performed, and whether tissue was sent to the laboratory. The surgeon signs at the bottom.

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    MED-FM-O25/REV.

    0/1JUL2015
    Republic of the Philippines
    Department of Health
    Field Operation
    Regional Health Office No. 10
    MAYOR HILARION A. RAMIRO SR. REGIONAL TRAINING AND TEACHING HOSPITAL
    Ozamiz City

    OPERATING ROOM RECORD


    NAME:______________________________________ AGE:______SEX:____CIVIL STATUS:______
    WARD:____________________BED NO.__________________HOSPITAL NO._________________
    PRE-OPERATIVE DIAGNOSIS:________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    POST-OPERATIVE DIAGNOSIS:_______________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    SURGEON:______________________________________________________________________
    1ST ASST.:___________________________________2ND ASST:_____________________________
    ANESTHESIOLOGIST:______________________________________________________________
    ASST./NURSE ANESTHETIST:________________________________________________________
    ANESTHESIA:____________________________________________________________________
    ANESTHETIC:____________________________________________________________________
    Time ANESTHESIA Begun:_____________________A.M/P.M______________________________
    DATE OF OPERATION:_____________________________________________________________
    Time ANESTHESIA Ended:___________A.M/P.M________________________________________
    TIME OF OPERATION BEGUN:________A.M/P.M____SURGICAL NURSE:_____________________
    TIME OPERATION ENDED:___________A.M/P.M____CIRCULATING NURSE:__________________
    OPERATION PERFORMED:__________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    _______________________________________________________________________________
    TISSUE TO LABORATORY YES ( ) NO ( )

    _________________________________
    SURGEON’S SIGNATURE

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