SCORE:

Riverside College Inc.

Bacolod City

DRUG TABULATION
PATIENT'S NAME: AGE: SEX: ROOM#:

ATTENDING PHYSICIAN: CHIEF COMPLAINT/S:

PRINCIPAL DIAGNOSIS/ ADMITTING IMPRESSION:

EVALUATION
SUBMITTED TO:
CONTENT 60%
Name of Drug 10%
Content 10%
MOA 15%
Indication/s 10%
NAME OF CLINICAL INSTRUCTOR/ STATION Contraindication/s 10%
Side Effects 15%
Nursing Considerations 30%

SUBMITTED BY: QUESTIONING 40%

100%
TOTAL

NAME OF STUDENT/ YEAR AND SECTION