COLLEGE OF NURSING

OPERATING ROOM Write-UP

Name of Student: Section & Group: Dates of Exposure:

Date of Admission:
Hospital: Ward:
Age: Sex: Civil Status: Religion:
Admitting Diagnosis:
Final diagnosis;
Operation Performed:

Instrument Nurse: Sponge Nurse:

Type of Anesthesia:
History of Present Illness:

Pathophysiology / Explanation of the Problem:

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Brief Discussion of Proposed Operation (How the surgeon performed the procedure):

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Instruments (uses / functions)

*Please refer lists of Major and Minor OR Cases on the attached.

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