IV/BT SHEET

PATIENT NAME: X AGE: 78yrs old HOSPITAL NO.: 1234

PHYSICIAN: DR. BAUTISTA SEX: MALE WARD/ROOM: MEDICAL WARD

SHIFT DATE IV FLUID/BLOOD RATE DATE/TIME FLUID RIE
TRANSFUSION
START END

MORNING 09/10/20 PNSS 1L X 10° x 3 cycles 7:00AM 3:00PM R- 1L

25 gtts I-800mL
E-200mL

AFTERNOON

NIGHT