San Pedro Hospital of Davao City, Inc.

C. Guzman St., 8000 Davao City, Philippines

Tel. No. (082) 222-6100 Fax No. (082) 226-4714
Website: www.sanpedrohospitaldavao.com
Email: sanpedrohospital@yahoo.com

VITAL SIGNS

Patient’s Name: ____________________________ Room and Bed No: _________________

DATE MEDICAL ORDER SHIFT TIME BP PR RR CR SPO2 REMARKS SIGNATURE OVER

PRINTED NAME
 SAN PEDRO HOSPITAL
GRAPHIC CHART
FAMILY NAME FIRST NAME ATTENDING PHYSICIAN ROOM NO. HOSPITAL NO.

Date
Hosp. Day
OPERATIVE
POST PARTUM
A.M. P.M. A.M. P.M. A.M. P.M. A.M. P.M. A.M. P.M. A.M. P.M. A.M. P.M.
Pulse Tem. 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12 4 8 12
C

160 41

150 40

140 39

130 38
BLACK/BLUE - TEMPERATURE

120 37
RED - PULSE

110 36

100 35

90

80

70

60

50
Respirations
Weight
Activity
Diet
Pt. Fed
Urine
Stool
 SAN PERO HOSPITAL
Davao City

VITAL SIGN MASTERY LIST

Date: _______________________________ Department: ____________________________

Shift 11 - 7 7 - 3 3 - 11
Room Name of Patients Medical Time BP PR CR Time BP PR CR Time BP PR CR
Order HR HR HR
 San Pedro Hospital of Davao City, Inc.
C. Guzman St., 8000 Davao City, Philippines
Tel. No. (082) 222-6100 Fax No. (082) 226-4714
Website: www.sanpedrohospitaldavao.com
Email: sanpedrohospital@yahoo.com

VITAL SIGNS

Patient’s Name: ____________________________ Room and Bed No: _________________

DATE MEDICAL ORDER SHIFT TIME BP PR RR CR SPO2 REMARKS SIGNATURE OVER

PRINTED NAME
 SAN PERO HOSPITAL
Davao City

VITAL SIGN MASTERY LIST

Date: _______________________________ Department: ____________________________

Shift 11 - 7 7 - 3 3 - 11
Room Name of Patients Medical Time BP PR CR Time BP PR CR Time BP PR CR
Order HR HR HR
 SAN PEDRO HOSPITAL
Davao City

T P R SHEET

DEPARTMENT:_____________________ _________________ 20___

4 A.M. 8 A.M. 12 Noon 8 P.M.

Room Name of Patient Temp. P R S U Temp. P R Temp. P R S U Temp. P R S U