ILOILO MISSION HOSPITAL

Mission Road, Jaro, Iloilo City

INTAKE AND OUTPUT RECORD

Name Tumangday Princess Age 21

Date May 09, 2023

Time Oral NGT OGT IVF/Blood & Blood Products (mL) Stool Urine (mL) Vomitus
8:00 40 IVL = 75 mL of D5LR
9:00 SDL = 100
10:00 60 100
11:00
12:00
1:00 40
2:00
3:00 30 100
8 HOURS TOTAL 170 200
4:00 IVL = 40 mL D5LR
5:00 30 SDL =
6:00
7:00 40
8:00
9:00 60
10:00 150
11:00
8 HOURS TOTAL 130 150
12:00 IVL = X mL D5LR
1:00 SDL =
2:00 45 75
3:00 150
 4:00
5:00 50 50
6:00
7:00 50
8 HOURS TOTAL 95 75 250

TOTAL INTAKE 24H 395 mL TOTAL OUTPUT 24H 600 Ml

Sex F Patient Hosp. Number C8 (E.H)

NGT OGT Vent Tube Colostomy Thoracotomy Tube Tube Drains