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Out of hours handover (please complete in block capitals)

Handover details
Handed over by Handed over to
Day(s) covered by this handover (please circle) Mon Tue Weds Thu Fri Sat Sun

Patient Responsible Diagnosis/problem list/ Reason for handover Outstanding issues Aims and limitations of treatment
surname, forename consultant, differential diagnosis (tasks to be done) (eg resus/ITU/ventilation/ inotropes/active/ palliative/
date of birth, patient current (include any risks or warnings) surgery – yes/no)
NHS hospital no location

Weekend discharge yes/no

Weekend discharge yes/no

Weekend discharge yes/no

Weekend discharge yes/no

Weekend discharge yes/no

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