APGAR SCORE CARD

Format No:

Patient Name: Mother’s Bed No:

D.O.B.-
T.O.B.- Mother’s IR No:

APGAR SCALE (EVALUATE @ 1 AND 5 MINUTES POSTPARTUM)

SIGN 2 1 0 1 MIN 5 MIN

A ACTIVITY (MUSCLE ACTIVE ARMS AND ABSENT

TONE) LEGS FIXED

P PULSE >100bpm <100bpm ABSENT

G GRIMACE (REFLEX Sneezes, coughs, Grimaces No Response

IRRITABILITY) pulls away

A APPEARANCE (SKIN Normal over entire Normal Cyanotic or Pale

COLOUR) body except all over
extremities

R RESPIRATIONS Good, Crying Slow, Absent

irregular

TOTAL

Signature of Doctor